Psychopharmacotherapy

Question 1

NT found in nucleus basalis

Answer 1

Ach

Question 2

NT found in VTA

Answer 2

DA; when it’s low»parkinson’s, when it’s high»psychosis

Question 3

NT found in locus ceruleus

Answer 3

NE; when it’s low»ADHD/anxiety, when it’s high»anxiety

Question 4

NT found in raphe

Answer 4

5HT/serotonin; when it’s low»depression

Question 5

DA pathways dysregulation - mesocortical

Answer 5

Negative symptoms (isolation, poor hygeine)

Question 6

DA pathways dysregulation - mesolimbic

Answer 6

Positive symptoms (delusions, AH/VH)

Question 7

DA pathways dysregulation - nigrostriatal

Answer 7

EPS (dystonia, akathisia, TD, NMS)

Question 8

DA pathways dysregulation - tuberoinfundibular

Answer 8

Prolactin Effects (gynecomastia, galactorrhea)

Question 9

Antipsychotics Side Effects

Answer 9

“HAM” histamine: weight gain, sedation; adrenergic: orthostasis, arrhythmias (QTc prolongation); muscarinic: delirium, blurry vision, zerostomia, constipation, urinary retention; + (all) lower seizure threshold

Question 10

Target of Anti-Psychotics

Answer 10

Typicals: DA receptor; Atypicals: DA and 5HT receptor

Question 11

Which agent carriers a risk for agranulocytosis?

Answer 11

Clozapine (clozaril), an atypical antipsychotic

Question 12

Side Effects of Lithium

Answer 12

Neurotoxicity, thyroid dysfunction, diabetes insipidus, leukocytosis, Ebstein’s anomaly; TW: 0.8-1.2mEq/L

Question 13

Side Effects of Carbamazepine

Answer 13

Induces own metabolism, Steven Johnson rash, blood dyscrasia, craniofacial defects; TW: 8-12 mcg/mL

Question 14

Side Effects of Valproic Acid

Answer 14

Hepatitis, blood dyscrasia, neural tube defects; 80-120 mcg/mL

Question 15

Which benzodiazepenes only undergo glucuronidation?

Answer 15

Lorazepam (ativan), oxazepam and temazepam

Question 16

Which serotinergic receptors are involved in the side effects of nausea, vomiting and diarrhea?

Answer 16

5HT3, 5HT4

Question 17

Which serotinergic receptors are involved in the side effects of (early) headaches/jitters? (Late) decreased libido and insomnia?

Answer 17

5HT2a, 5HT2c

Question 18

Which antidepressant is beneficial for patients with comorbid pain syndromes?

Answer 18

SNRIs

Question 19

Which antidepressant is beneficial for patients who do not want sexual dysfunction side effects?

Answer 19

Bupropion (wellbutrin + zyban), an NDRI

Question 20

Which antidepressant promotes sleep and appetite?

Answer 20

Mirtazapine (remeron)

Question 21

Which benzodiazepine carries the highest risk of abuse?

Answer 21

Alprazolam (xanax)

Question 22

What is a life-threatening risk associated with increased serotonin?

Answer 22

Serotonin Syndrome

Question 23

What is perphenazine and what is it’s trade name?

Answer 23

Typical antipsychotic with mid-range efficacy and SE aka trialfon

Question 24

What is chlorpromazine and what is it’s trade name?

Answer 24

Typical antipsychotic with low-range efficacy and SE aka thorazine

Question 25

What is olanzapine and what is it's trade name?

Answer 25

Atypical antipsychotic aka zyprexa with SE of metabolic syndrome

Question 26

What is risperidone and what is it's trade name?

Answer 26

Most like typical antipsychotics aka risperdal

Question 27

What is fluphenazine and what is it's trade name?

Answer 27

Typical antipsychotics aka prolixin

Question 28

What is haloperidol and what is it's trade name?

Answer 28

Typical antipsychotic aka haldol

Question 29

What is quetiapine and what is it's trade name?

Answer 29

Atypical antipsychotic aka seroquel with SE of sedation and orthostasis

Question 30

What is apriprazole and what is it's trade name?

Answer 30

Atypical antipsychotic aka abilify that is a partial DA agonist with least metabolic syndrome SE

Question 31

What is ziprasidone and what is it's trade name?

Answer 31

Atypical antipsychotic aka geodon with SE of QTc prolongation

Question 32

What is clozapine and what is it's trade name?

Answer 32

Atypical antipsychotic aka clozaril with SE of agranulocytosis, seizures, cardiomyopathy, hypotension and drooling but good for patients with TD and suicidality

Question 33

What is lamotrigine?

Answer 33

An anti-convulsant used for prevention of depression aka lamictal

Question 34

What is clonazepam?

Answer 34

A benzodiazepine with long onset and duration aka klonopin