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THE EXAM > Psychopharm > Flashcards

Psychopharm Flashcards

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1
Q

what receptor do SSRIs block

A

SERT

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2
Q

which receptor is upregulated in depression

A

5HT1A

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3
Q

what is the hypothesis around why SSRIs take 4-6 w to have an effect

A

bc there needs to be downregulation of the 5hT1a pre-synaptic receptor in response to increase 5ht

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4
Q

what effect do AD augmenters (i.e aripip) have on 5HT1a

A

partial agonists that downregulate 5ht1a

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5
Q

what portion of patients remit on their first AD (accord to STARD)

A

1/3

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6
Q

activation of which receptor is responsible for sexual dysfnx side effects

A

5hT2a

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7
Q

activation of which receptor is responsible for GI side effects

A

5Ht3A

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8
Q

activation of which receptors is responsible for activation/anxiety (name 4)

A
  1. 5ht2a. 2. 5ht2c. 3. NE. 4.DA
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9
Q

activation of which receptor is responsible for akathasia in SSRI use

A

5HT2A

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10
Q

what is the MOA of TCAs

A

reuptake inhibition of 5HT, NE and DA

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11
Q

why do MAOIs have the potential for a hypertensive crisis?

A

MAO- A metabolizes tyramine, but if MAO-A in the gut is inhibited it causes a dangerous amount of tyramine

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12
Q

what does MAO-A metabolize (4 answers)

A

1 5ht. 2. NE. 3. DA. 4. tyramine

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13
Q

what does MAO-B metabolize (2 answers)

A
  1. Da. 2. tyramine
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14
Q

how long should the wash out period for MAOIs be

A

14 days

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15
Q

what is the interaction bw fluvoxamine and clozapine

A

fluvoxamine inhibit 1A2 which metabolizes clozapine (hence it causes clozapine levels to increase)

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16
Q

what is the effect of fluoxetine and paroxetine on TCAs?

A

Both those ADs are 2D6 inhibitors which metabolize TCAs (hence they cause TCAs to increase)

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17
Q

Acronym associated with NMS

A

FEVER= fever, encephalopathy, vital instability, elevated enzymes (CK), rigidity

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18
Q

what is the interaction bw chlorpromazine and codeine`

A

cpz inhibitis 2D6 which is an enzyme that breaks down codeine into morphine (so it prevents break down into morphine)

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19
Q

which cyp metabolizes amphetamines

A

2D6

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20
Q

what is paroxetine’s interaction with tamoxifen

A

p inhibits 2d6 which metabolizes t into its active drug (paroxetine decreases active drug of t)

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21
Q

how is paliperidone cleared

A

renal

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22
Q

which ion is responsible for the depolarization phase of an action potential

A

Na influx

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23
Q

which ion is responsible for the repolarization of an AP

A

K efflux

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24
Q

carbamazepine’s effect on benzo

A

czp induces 3A4 so it decreases benzo levels

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25
smoking effect on clozapine, olz
smoking induces 1A2 which metabolizes these APs (so smoking decreases AP levels)
26
which cyp does grapefruit act on
inhibits 3A4
27
what is the interaction bw ASA and Valproic
ASA displaces valproic from the protein so it increases free valproic levels
28
moa of varenicline
partial agonist at alpha 4 beta 2 nicotine receptors
29
which cyp metabolizes carbamazapine
3a4 (which is also the cyp it induces, so it induces it's own metabolism)
30
which cyp does nefazadone inhibit
3A4
31
carbamazaepine's effect on lamotrigine
decreases l's levels
32
what's the moa of benzos
agonist of GABAa receptors in the limbic system
33
moa of buspirone
partial 5ht1a agonist
34
what is caffeine's effect on Li levels
decrease Li by increasing renal clearance
35
what is Li's effect on cellular ions?
it displaces K from inside the cell (intracellular)
36
what signs are seen on ECG of someone taking Li
signs of hypokalemia (T wave inversion, and flattening)
37
below which WBC or ANC does one d/c clozapine
WBC <2 ANC <1
38
what is the rate of agranulocytosis with clozapine
1%
39
which cyp does erythromycin affect
inhibits 3a4
40
what is bromocryptine
dopamine agonist (used in NMS, hyper-prolactinemia)
41
which brain regions (2) are responsible for hyperprolactinemia
tuberinfundibular region that dumps dopamine into anterior pituitary
42
what is Li's effect on parathyroid and Ca?
hyper parathyroidism and increased Ca
43
moa of psychostimulants
release NE and DA
44
what is ziprasidone's effect on histamine
H1 antagonist
45
which cyp converts codeine to morphine
2D6
46
what is the risk of combing dextromethrophan with neuroleptics
serotonin syndrome
47
which part of the synapse does COMT act
post synaptic
48
treatment of SS
cyproheptadine (anti-5ht)
49
what is the effect of caffeine on clozapine
increases its clozapine levels
50
what is responsible for clozapine hypersalivation
M4 agonism
51
how long should you wait before starting an AD once stopping moclobemide
24hrs
52
how does Li cause hypothyroidism
prevents coupling of residues to form T3 + T4
53
how does valproic increase lamotrigine levels
through glucuronidation inibition
54
deficiency in which vitamin is MAOIs linked to
B6
55
least qtc prolonging AP
latuda
56
person with COPD on theophylline which AD to avoid
fluvoxamine
57
moa of pregabalin
acts on Ca channel
58
most noradrenergic of the SNRIs
levomilnacipran
59
best AD to add to aripiprazole
venlafaxine (aripip is a 2D6 substrate which is not affected by venlafaxine)
60
which recreational drug is most likely to cause dementia
inhalants
61
what is the MOA of benzos
increases the binding of GABA to its receptor
62
for which cancer related condition should morphine be added to a AD
bone mets
63
alexithymia is associated with which medical illness
IBS
64
what is the effect of fluvoxamine on tacrolimus
fluvoxamine inhibits tacrolimus metabolism (CYP3A4)
65
which AP has the fastest off D2
clozapine
66
which AD has least impact on qtc
buproprion

THE EXAM (19 decks)

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