Psychotropics In Clinical Setting

Question 1

Mechanism of action of antipsychotics

Answer 1

to block (or partially
block) dopamine
receptors in the
mesolimbic area of the
brain

Question 2

Side effects of the 1st gen antipsychotics

Answer 2

Extrapyramidal manifestations due to block of dopamine in nigrostriatal pathway

Question 3

Mechanism of action of 2nd generation antipsychotics

Answer 3

5HT2A and D2 antagonists;

Question 4

Mechanism of action of 3rd gen antipsychotics

Answer 4

dopamine partial agonists

Question 5

1st line treatment of Antidepressants

Answer 5

SSRI (citalopram)

Question 6

What are the labs required for use of SSRI

Answer 6

CBC, U&E (hyponatremia), ECG (long QTC)

Question 7

2nd line Antidepressants

Answer 7

Another SSRI

Question 8

Mood stabilizers are used to treat….

Answer 8

Bipolar

Question 9

Most commonly used mood stabilizer

Answer 9

Lithium

Question 10

Mechanism of action of Lithium (mood stabilizers)

Answer 10

inhibition of
secondary messenger
enzymes
• By modulation of G proteins
• By interaction at various sites
within the downstream signal
transduction cascades (eg
inhibition of GSK
3)

Question 11

1st line tx of bipolar affetive disorder

Answer 11

Na valproate

Question 12

Mechanism of action of Na valproate

Answer 12

• It blocks voltage-sensitive sodium channels and
increases brain concentrations of gammaaminobutyric acid (GABA)

Question 13

Drug used for tx of acute mania and prophylaxis of bipolar

Answer 13

Carbamazepine

Question 14

Mec. Of action of carbamazepine

Answer 14

• It blocks voltage sensitive Na+ channels to reduce
glutamate release and decreases turnover of
norepinephrine and dopamine.

Question 15

How is Lithium excreted

Answer 15

By kidney

Question 16

Buspirone is used to treat…..

Answer 16

Generalised anxiety disorder

Question 17

1st line tx for mild depression in children and adolescents

Answer 17

Psychological support

Question 18

Tx for mod/ severe depression in young people

Answer 18

psychological therapy, either alone or in
combination with antidepressant medication

Question 19

1st kine Antidepressants in children and young people

Answer 19

Fluoxetine

Question 20

TriFluoPerazine is a drug of which category of the following;

. 1st gen antipsychotics
. 2nd gen antipsychotics
. 3rd gen antipsychotics

Answer 20

1st gen antipsychotics

Question 21

A pregnant woman takes haloperidol for her psychosis, what are the complications that might happen to the baby due to Haloperidol use?

Answer 21

Limb defects
Low birth weight
Preterm birth

Question 22

A patient with renal impairment is taking haloperidol for psychotic symptoms, do you recommend we change something about the dose of haloperidol?
. Reduce dose
. Increase dose
. No Change required

Answer 22

No change required

Question 23

A patient has been taking haloperidol for his psychosis, after a while of use the patient developed neuroleptic malignant syndrome,
what is the treatment of this case?

Answer 23

. Muscle relaxants
. Dopamine agonists: Bromocriptine

Question 24

What is the 2nd Gen antipsychotic used in resistant cases of psychosis? (last line)

Answer 24

Clozapine

Question 25

A schizophrenia patient takes an antipsychotic, in the past two days he becomes feverish, the dr suspects an infection, lab reports show neutropenia and agranulocytosis, What is the most likely drug that has caused this clinical picture? . Haloperidol . Olanzapine . Clozapine . Aripiprazole What are other side effects of this drug?

Answer 25

Clozapine, Other side effects : . Metabolic syndrome . Myocarditis . Sedation

Question 26

True or false Clozapine is contraindicated in liver impairment

Answer 26

True

Question 27

Patient taking clozapine with another drug, the drug interaction has caused an increase in incidents of seizures due to CYP 2D6 inhibition, what is the other drug used?

Answer 27

Fluoxetine

Question 28

A pregnant woman delivers her baby and starts breastfeeding him, her doctor prescribed her an antipsychotic for mild psychosis, what is the first line post-partum antipsychotic?

Answer 28

Olanzapine Or Quetiapine

Question 29

What is the agent of choice for Non cognitive symptoms associated with dememtia

Answer 29

Risperidone

Question 30

1st line SSRI in elderly depression

Answer 30

Sertraline

Question 31

1st line SSRI in Adolescent and child depression

Answer 31

Fluoxetine

Question 32

What is the safest SSRI in pregnancy? . Sertraline . Citalopram . Escitalopram . Fluoxetine

Answer 32

Fluoxetine

Question 33

Mention 4 SSRIs you know

Answer 33

Sertraline Citalopram ESCITALOPRAM FLUOXETINE FLUROXAMINE Paroxetine

Question 34

A pregnant lady is taking an SSRI for her depression, on her follow up with the obstetrician, he told her that her baby has a cardiac malformation. What is the SSRI that she is using and caused the cardiac malformation?

Answer 34

Paroxetine

Question 35

Venlafaxine, Duloxetine are two antidepressants of which subtype (class of drugs)

Answer 35

SNRI

Question 36

Mechanism of action of mirtazapine

Answer 36

Antidepressant (Noradrenergic and specific serotonergic antidepressant) (NaSSA)

Question 37

Which anticonvulsant of yhe follwing causes Steven johnson syndrome? . Valproate . Carbamazepine . Lamotrigine

Answer 37

Lamotrigine

Question 38

Indication of buspirone (anxiolytics)

Answer 38

Generalized anxiety disorder