Psychopharmacology

Question 1

What are some side effects of Adderall?

Answer 1

What are some side effects of Adderall? Weight loss, insomnia, exacerbation of ticks, decreased seizure threshold.

Question 2

What is the generic name of an Adderall

Answer 2

amphetamine

Question 3

What’s the generic name of Ritalin

Answer 3

What’s the generic name of Ritalin?methylphenidate.

Question 4

What’s the generic name for Concerta?

Answer 4

What’s the generic name for Concerta?methylphenidate.

Question 5

What are some Side effects of Ritalin?

Answer 5

Side effects of Ritalin? Leukopenia, anemia, weight loss, insomnia, exacerbation of ticks, decreased seizure threshold.

Question 6

What are the major classes of medications used for major neurocognitive disorder/dementia?

Answer 6

Acetylcholinesterase inhibitor’s, glutamate receptors antagonist/NMDA receptor antagonist.

Question 7

Why do we use Succinylcholine?

Answer 7

It is a muscle relaxer and that we use for ECT

Question 8

What is deep brain stimulation used for?

Answer 8

Parkinson’s disease, disabling dystonia, chronic pain, tremors, major depression.

Question 9

What is repetitive transcranial magnetic stimulation used for?

Answer 9

Major depression, however side effects include seizures headaches and scalp pain.

Question 10

What do you use for maintenance phase of bipolar disorder?

Answer 10

Lithium, valproic acid, lamotrigene, quetiapine, aripiprazole, intramuscular risperidone

Question 11

TCA side effects

Answer 11

Histamine: weight gain, sedation
Alpha one: orthostasis, CARDIAC ARRHYTHMIAS
Muscarinic: delirium, blurry vision, dry mouth, constipation, urine retention
Tachycardia, PROLONGED QT INTERVAL, sexual dysfunction, decreased seizure threshold

Question 12

Side effects of SSRI

Answer 12

G.I.: nausea and vomiting, diarrhea, constipation, anorexia
Anxiety, agitation, insomnia
CNS: tremor, somnolence, headache
Sweating, dizziness
Sexual: anorgasmia, delayed ejaculation, erectile dysfunction, decreased libido

SIADH: leads to hyponatremia
Increased suicidality
Serotonin syndrome

Question 13

Side effects of SNRI

Answer 13

Same as SSRI, plus:
Increased blood pressure and heart rate
Irritability, aggression, sédation, fatigue
Urinary hesitancy or retention

Question 14

Side effects of benzodiazepines

Answer 14

Dependence and with drawl the risk (short term only)
Increased risk for elderly (delirium, falls, cognitive impairment)
Amnesia
Respiratory depression (don't use olanzapine + Ativan)

Question 15

What are the symptoms of withdrawal for heroine use

Answer 15

Dysphoria, insomnia, lacrimation, rhinorrhea, yawning, weakness, sweating, piloerection, nausea and vomiting, fever, dilated pupils, abdominal cramps, arthralgia, myalgia, hypertension, tachycardia, and crazy.

Question 16

What do you use to treat the with drawl symptoms of heroin

Answer 16

Clonidine

Question 17

What are the with drawl symptoms of cocaine

Answer 17

Malaise, fatigue, hypersomnolence, depression, anhedonia, hunger, CONSTRICTED PUPILS, vivid dreams, psychomotor agitation, or retardation,

Question 18

How do antidepressants exert their therapeutic effect

Answer 18

By increasing catecholamines

Question 19

What do you have to watch out for when you use MAOIs

Answer 19

Risk of hypertensive crisis when used with sympathomimetics or ingestion of tyramine rich foods such as wine, beer, each cheeses, liver and smoked meats

Question 20

What are some melancholic features for depressive disorder’s?

Answer 20

Anhedonia, early-morning awakening is, depression worse in the morning, psychomotor disturbance, excessive guilt, anorexia

Question 21

What are atypical features in depressive disorder

Answer 21

When you have manic or hypomanic symptoms present during the majority of days during a major depressive episode

Question 22

What’s the Triad for seasonal affective disorder?

Answer 22

Irritability, carbohydrate cravings, hypersomnia

Question 23

What is rapid cycling?

Answer 23

Rapid cycling is defined by the occurrence of four or more mood episodes in one year (major depressive, hypo manic, or manic).

Question 24

What medication should be used for rapid cyclers?

Answer 24

Carbamazepine

Question 25

Criteria: persistent depressive disorder?

Answer 25

``` CHASES. 2+ of: Poor concentration/difficulty making decisions Hopelessness Poor appetite or over eating Insomnia or hypersomnia No energy or fatigue Low self-esteem ``` 2 years of depression 2 listed criteria Never asymptomatic for more than 2 months

Question 26

Treatment for persistent depressive disorder

Answer 26

Combination treatment with psychotherapy and pharmacotherapy is more efficacious then either alone. Cognitive therapy, interpersonal therapy, and insight oriented psychotherapy are the most effective. SSRIs, TCAs, MAOIs

Question 27

What are the cognitive domains affected in neurocognitive disorders ?

Answer 27

Complex attention, executive function, learning and memory, and language, perceptual-motor skills, social cognition (interaction).

Question 28

What are the broad categories of delirium?

Answer 28

``` Substance intoxication delirium Substance with drawl delirium Medication induced delirium Delirium due to another medical condition Delirium due to multiple aetiologies ```

Question 29

What is the clinical tool used for suspected delirium?

Answer 29

Confusion Assessment Method (CAM)

Question 30

Once delirium has been diagnosed, what investigations should be carried out?

Answer 30

``` Fingerstick blood glucose Pulse oximetry Arterial blood gases Electrocardiography Metabolic panel CBC Urinanalysis Urine culture Urine drug screen A blood alcohol level Therapeutic drug levels Hepatic panel Thyroid hormone levels Chest x-ray Head CT, EEG, lumbar puncture ```

Question 31

What is the preferred agent for delirium?

Answer 31

Haloperidol

Question 32

What's the thing between benzodiazepine and delirium

Answer 32

Benzodiazepines can cause, worsen, or prolong delirium so do NOT use unless treating delirium due to alcohol or benzodiazepine withdrawl

Question 33

What's the main difference between mild neurocognitive disorder and major Neurocognitive disorder?

Answer 33

Mild neurocognitive disorder: is able to perform IADLs | Major neurocognitive disorder: impaired performance of I ADLs/ADLs

Question 34

DX: cognitive impairment with stepwise increase in severity and focal neurologic signs

Answer 34

Vascular disease (mild or major neurocognitive disorder)

Question 35

What are the components of the Mini mental state exam?

Answer 35

Orientation Registration – name three objects and repeat them Attention – serial sevens or spell "world" backward Recall Language – no if's and's or butts verbal comprehension, written comprehension visual spatial skills

Question 36

What is the treatment for Alzheimer's disease?

Answer 36

No cure truly effective treatment Cholinesterase inhibitor's, e.g. donepezil, rivastigmine NMDA receptor antagonist: memantine

Question 37

Core features of Louis body disease

Answer 37

Progressive cognitive decline Visual hallucinations Parkinsonism at least one year after cognitive decline becomes evident R.E.M. sleep behaviour disorder

Question 38

Treatment for Louis body disease

Answer 38

Cholinesterase inhibitor's for cognitive and behavioural problems Quetiapine or clozapine for psychotic symptoms Levodopa-carbidopa for parkinsonism Melatonin and/or clonazepam for rapid eye movement sleep behaviour disorder

Question 39

What are the clinical manifestations of normal pressure hydrocephalus?

Answer 39

Three Ws of normal pressure hydrocephalus Wobbly = gate disturbance Wet = urinary incontinence Wacky = cognitive impairment