Psychiatry

Question 1

Alcohol withdrawal

Answer 1

Benzodiazepines

Question 2

Anxiety

(3)

Answer 2

SSRIs

SNRIs

Buspirone

Question 3

ADHD

(2)

Answer 3

Methylphenidate

Amphetamines

Question 4

Bipolar disorder

(2)

Answer 4

Mood stabilizers

(lithium, valproate, carbamazepine)

Atypical antipsychotics

Question 5

Bulimia

Answer 5

SSRIs

Question 6

Depression

(5)

Answer 6

SSRIs

SNRIs

TCAs

Buspirone

Mirtazepine

Question 7

OCD

(2)

Answer 7

SSRIs

Clomipramine

Question 8

Panic disorder

(3)

Answer 8

SSRIs

Venlafaxine

Benzodiazepines

Question 9

PTSD

Answer 9

SSRIs

Question 10

Schizophrenia

Answer 10

Antipsychotics

Question 11

Social phobias

Answer 11

SSRIs

Question 12

Tourette’s syndrome

Answer 12

Antipsychotics

(haloperidol, risperidone)

Question 13

Increases catecholamines (DA, NE) at synaptic cleft

(3)

For ADHD, narcolepsy, appetite control

Answer 13

CNS stimulants

Methylphenidate

Dextroamphetamine

Methamphetamine

Question 14

Block D2 receptors

(increase cAMP)

For schizophrenia, psychosis, acute mania, Tourette’s

Extrapyramidal signs, hyperprolactinemia, dry mouth, constipation, hypotension, sedation

Neuroleptic malignant syndrome, tardive dyskinesia

Answer 14

Typical antipsychotics

Haloperidol

-azines

(trifluoperazine, fluphenazine, thioridazine, chlorpromazine)

Question 15

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia

Treatment?

(2)

Think FEVER

Answer 15

Neuroleptic malignant syndrome

Dantrolene

D2 agonists (bromocriptine)

FEVER

Fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles

Question 16

Stereotypic oral-facial movements

Long-term antipsychotic use

Treatment?

Answer 16

Tardive dyskinesia

Irreversible, no treatments.

Question 17

High potency antipsychotics

“Try to Fly High”

Neurologic side effect (extrapyramidal signs)

Answer 17

Trifluoperazine, fluphenazine, haloperidol

Question 18

Low potency antipsychotics

“Cheating Thieves are low”

Non-neurologic side effects

anticholinergic, antihistamine, alpha-1 blockade

Other side effects?

Answer 18

Chlorpromazine- corneal deposits

Thioridazine- retinal deposits

Question 19

Effects on 5-HT2, DA, alpha and H1 receptors

For schizophrenia, bipolar, OCD, anxiety disorder, depression, mania, Tourette’s

Few extrapyramidal, anticholinergic symptoms

Weight gain (2)

Agranulocytosis, seizure (1)

Long QT (1)

Answer 19

Atypical antipsychotics

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone

Weight gain- olanzapine, clozapine

Agranulocytosis, seizure- clozapine

Long QT- ziprasidone

Question 20

Unknown mechanism, possibly inhibition of

phosphoinositiol cascade

For bipolar (blocks relapse, acute mania), SIADH

Tremor, sedation, edema, heart block, hypothyroidism, polyuria, teratogenesis

Narrow therapeutic window

Reabsorption at PCT following Na+ reabsorption

Answer 20

Lithium

Question 21

Can cause fetal cardiac defects

Ebstein anomaly

Malformation of the great vessels

Answer 21

Lithium

Question 22

Stimulates 5-HT1A receptors

For generalized anxiety disorder

No sedation, addiction, tolerance, interactions with alcohol

Answer 22

Buspirone

Question 23

Serotonin-specific reuptake inhibitors

(4)

For depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD

GI distress, sexual dysfunction, serotonin syndrome

Take 4 to 8 weeks for effect

Answer 23

SSRIs

Fluoxetine, paroxetine, sertraline, citalopram

Question 24

Hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures

Treatment?

Answer 24

Serotonin syndrome

(from MAOIs, SNRIs, SSRIs, TCAs)

Tx: cyproheptadine

(5-HT2 receptor antagonist)

Question 25

Inhibit serotonin, NE reuptake (2) For depression For generalized anxiety disorder, panic disorder (1) For diabetic peripheral neuropathy (1) Raises BP, stimulant effects, sedation, nausea

Answer 25

SNRIs Venlafaxine (anxiety, panic) Duloxetine (neuropathy) Duloxetine has greater effect on NEs

Question 26

Inhibits serotonin, NE reuptake For major depression, bedwetting (1), OCD (1), fibromyalgia Causes sedation, alpha-1 block (hypotension), cholinergic block (tachycardia, urinary retension, dry mouth), seizures, coma, arrhythmias, respiratory depression, fever, confusion, hallucinations. How to treat cardiotoxicity?

Answer 26

TCAs Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine Anticholinergic: amitriptyline \> nortriptyline Desipramine less sedating, less seizure Tx for cardiotox: NaHCO3

Question 27

Monoamine oxidase inhibition Increases NE, serotonin, dopamine For atypical depression, anxiety, hypochondriasis Hypertensive crisis (tyramines), CNS stimulation Contra: SSRIs, TCAs, St. John's wort, meperidine, dextromethorphan

Answer 27

MAOIs Tranylcypromine, phenelzine, isocarboxazid, selegiline Selegiline selective for MAO-B

Question 28

Atypical antidepressant Increases NE, dopamine Used for smoking cessation SE: stimulant, headache, seizure (bulimics) No sexual side effects

Answer 28

Bupropion

Question 29

Atypical antidepressant alpha-2 antagonist Increases release of NE, serotonin Potent 5-HT2, 5-HT3 antagonist SE: sedation (good for depression + insomnia), increased appetite, weight gain (good for elderly, anorexics), dry mouth

Answer 29

Mirtazapine

Question 30

Atypical antidepressant Blocks NE reuptake SE: sedation, orthostatic hypotension

Answer 30

Maprotiline

Question 31

Atypical antidepressant Inhibits serotonin reuptake For insomnia SE: sedation, nausea, priapism, postural hypotension

Answer 31

Trazodone