psych

Question 1

Lithium Toxic range

Answer 1

Blood level >1.5

Question 2

Which mood stabilizer reduce the risk of suicide?

Answer 2

Lithium

Question 3

What are the side effects of lithium?

Answer 3

1) nephrogenic diabetes insipidus
2)hyperparathyroidism
3)hypothyroidism
4) tremors
5) Hypercalcemia
6) Hypermagnesium
7) Interstitial nephritis
8) Ebstein anomaly (congenital heart defect of tricuspid valve)

Question 4

What medications are known to increase the levels of lithium?

Answer 4

ACEi/ARB, diuretics, NSAIDs

Question 5

What are the side effects of Valproate?

Answer 5

Pancreatitis
Liver toxicity
Increase lamotrigine levels

Question 6

What is the side effect of lamotrigine?

Answer 6

Cause SJS/TEN

Question 7

What is a side-effect of carbamazepine?

Answer 7

Aplastic anemia, agranulocytosis (increase bleeding, bruising, mouth sores)

Question 8

SSRI’s can be used off brand to treat?

Answer 8

Premature ejaculation

Question 9

Only FDA approved antidepressant to treat Bulimia?

Answer 9

Fluoxetine (low risk for weight gain)

Question 10

Which SSRI has more sexual dysfunction SE?

Answer 10

Paroxtine

Question 11

The only antidepressant used to treat menopause vasomotor sxs?

Answer 11

Paroxetine

Question 12

Side effects of paroxetine?

Answer 12

1) More sexual dysfunction
2) anti-histamine activity
3) More anticholinergic activity (dry mouth, weight gain, dry eyes)

Question 13

Which SSRI should be avoid in patients with QT prolongation?

Answer 13

Citalopram

Question 14

If patient is fearful of sexual dysfunction. Which anti-depressant can be used?

Answer 14

Bupropion, its also good to smoking cessation

Question 14

What is the most serious side effect of buproion?

Answer 14

lowers the seizure threshold (increases the risk of seizure) and increases the risk of suicidal ideation

especially in patients with eating disorders

Question 14

Which SNRI is best used to treat neuropathic pain and fibromyalgia?

Answer 14

Duloxetine

Question 14

Venlafaxine should be avoided in patients with ?

Answer 14

HTN. can increase BP

Question 14

Tricyclic antidepressants drugs names

Answer 14

Amitriptyline, nortriptyline
Clomipramine, Imipramine, Doxepin

Question 15

Which TCA drug is FDA approived for obsessive compulsive disorder

Answer 15

Clomipramine

Question 16

Which TCA drug is used to treat nocturnal enuresis in children if desmopressin fails?

Answer 16

Imipramine

Question 17

TCA are known to cause what MAJOR sided effect

Answer 17

Anticholinergic symptoms
1) QT prolongation
2) Seizures-> lowers seizure threshold
3) Coma (AMS)

Question 18

What is the 1st line treatment for TCA overdose

Answer 18

IV SODIYM BICARBINATE

Question 19

Which TCA drug is good for treating neuropathic pain

Answer 19

Amitriptyline

Question 20

What are MAO inhibitor drugs?

Answer 20

Tranylcypromine, phenelzine, selegiline, Isocarboxazid

Question 21

What is a serious adverse effect of MAO inhibitors?

Answer 21

Hypertensive Crisis: after eating foods high in tyramine (aged cheese, smoked, pickled or cured meat, red wine. MAO inhibitor prevent the break down of tyramine.

Question 22

What is the treatment of MAO inhibitor tyramine induce hypertensive crisis?

Answer 22

Phentolamine

Question 23

What is a side effect of trazadone?

Answer 23

Priapism

Question 24

Presentation of serotonin syndrome/toxicity

Answer 24

initiation or increase dose of a medication that increase serotonin Altered mental status-> anxiety, agitation Autonomic instability: hyperthermia, HTN, tachycardia Neuromuscular hyperactivity: clonus, increased DTR/hyperreflexia

Question 25

What is the treatment of serotonin syndrome?

Answer 25

Benzo for agitation + Cyproheptadine (serotonin antagonist)

Question 26

neuroleptoc malignant syndrome sxs

Answer 26

1) automonic instability: fever,sweating 2)AMS: confusion 3) Muscular (lead pipe) rigidity

Question 27

treatment of neuroleptic malignant syndrome

Answer 27

dantrolene or bromocriptine

Question 28

16 year old is brought to the ED due to progressive confusion and agitation for the past several hours. His friends report that the boy started to act bizarre after consuming an unknown substance. The patient reports blurred vision. He also frequently interrupts ED staff for a drin of water. The patient is mucous membrane and skin is dry, his face is warm and flushed. Bladder is distended but the patient is unable to urinate. This patient has overdosed on?

Answer 28

Atropine: an anti-cholinergic