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1

Person has generalized anxiety with an acute onset of recent attacks. What drugs do you give them for short and long term?

What if they have a hx of heroin and alcohol abuse? Downside to this drug?

Short term - benzo
Long term - SSRI

Addictive personality - give buspirone, but it takes 1-2 weeks for effects.

2

Do not give fluoxetine with what S-H?

Do not give fluoxetine (SSRI) with Ramelteon (melatonin S-H) bc of CYP inhibiton by fluoxetine

3

Treatment of EPS

trihexylphenydyl, benztropene, diphenhydramine

4

EPS worst with?

Haloperidol and all typical anti-psychotics

5

Anti-depressants:
sedation, muscarinic, hypotension

typicals - chlorpromazine, fluphenazine, haloperidol

6

indications for what drug: tx resistant schizophrenia and suicide.

clozapine (anti-psychotic)

7

adverse effects of clozapine -
agranulocytosis and....

metabolic syndrome

8

monitor thyroid function in pts taking

Lithium
Movement (tremors)
Nephrogenic DI
hypOthyroid
Pregnancy Contraindicated

9

prolonged QT interval

ziprasidone (atypical antidepressant)
and haloperidol

10

elevated PRL levels

risperidone and Haloperidol (and all typical antipsychotics)

11

Main (only-ish) side effect is seizures when administered at high doses treatment for anorexia and bulemia, as well as 1st line tx of depression with hypersomnia.

Buproprion (NDRI - anti depressant)

12

High potency v. low potency typical antidepressants

High potency (neuro EPS) - fluphenazine, haloperidol
Low potency (alpha, Histamine, anti-cholinergic) - chlorpromazine

13

suicide prevention (two drugs)

lithium (antipsychotic mood stabilizer) clozapine (atypical antidepressant)

14

sexual dysfunction in 1/2 of all patients on ___ class

What does not cause sexual dysfunction?

SSRI

buproprion

15

Low potency anti-depressants have these side effects (along with TCAs)

alpha (orthostatic hypot), Histamine, anti-cholinergic -const/dry mouth/dizzy

16

Highly sedating antidepressant
Priapism

Trazodone

17

Drug that inhibits reuptake of monoamines (NE, dop, 5HT). Increases sympathetics. Coronary artery vasospasm (Myocardial ischemia).

cocaine

18

Best treatment for alcohol withdrawal.

Benzodiazepines.
Diazepam (long acting bezo- best). BAD for liver.
Lorazepam, oxazepam (short acting benzo). BETTER for liver.

19

What drug in treatment of alcohol dependence decreases cravings?

MOA?

Naltrexone

Mu-opioid receptor antagonist

20

What drug in treatment of alcohol dependence does not decrease cravings, but causes aversion?

MOA

Disulfram

ALDEHYDE dehydrogenase inhibitor

21

MOA of acamprosate.

NMDA receptor antagonist and GABA agonist.

22

Non-benzo used to treat insomnia.

Zolpidem and zaleplon (fall asleep), eszopiclone (stay asleep)

23

Suspect what?
Fever
Encephalopathy (confusion)
Vitals (temp/BP)
Enzyme elevation
Rigidity

Neuroleptic Malignant Syndrome (antipsychotic side effect)

24

Serotonin Syndrome

Activity (tremor)
Agitation
Autonomics (hypertension, hyperthermia, tachycardia)

25

TCA toxicity

Cardiotoxicity
Convulsions
Coma

26

acute dystonia (mm contractions), akathisia (leg restlessness), dyskinesia, parkinson-like movements (tremor, rigidity, bradykinesia, masked facies)

EPS (typical > atypical side effect)

27

Involuntary movement after chronic use (lip smacking).

Tardic dyskinesia

28

Muscle contractions in EPS

acute dystonia

29

Leg restlessness in EPS

akathisia

30

Tremor, rigidity, bradykinesia, masked facies in EPS

Parkinson-like