schizophrenia

Question 1

how does blockage of dopamine receptors mesolimbic tract affect?

Answer 1

dopamine blockade prevents overactivity responsible for positive symptoms

Question 2

how does blockage of dopamine receptors in mesocortical tract affect

Answer 2

hypofunction results in negative unwanted sx

Question 3

how does blockage of dopamine receptors in nigrostriatal tract affect

Answer 3

blockade causes epse

Question 4

how does blockage of dopamine receptors in tuberinfundibular tract affect

Answer 4

dopamine blockade leads to hyperprolactinemia

Question 5

therapeutic effects of D2 antagonism

Answer 5

reduces positive sx

Question 6

side effects of D2 antagonism

Answer 6

epse, hyperprolactinemia

Question 7

therapeutic effects of 5HT1A agonism

Answer 7

anxiolytic properties

Question 8

therapeutic effects of 5HT2A antagonism

Answer 8

antidepressant effects, improve negative sx

Question 9

side effects of 5HT2C antagonism

Answer 9

weight gain

Question 10

side effects of H1 antagonism

Answer 10

sedation / weight gain

Question 11

side effects of alpha 1 antagonism

Answer 11

orthostasis

Question 12

side effects of m1 antagonism

Answer 12

anticholinergic effects (acute urinary retention, delirium)

Question 13

side effects of IKR antagonism

Answer 13

QTc interval prolongation

Question 14

clozapine monitoring

Answer 14

weekly WBC and ANC count for first 18 weeks, then monthly

Question 15

why avoid in elderly with dementia

Answer 15

increased risks for mortality and stroke

Question 16

if patient is uncooperative during acute agitation

Answer 16

IM lorazepam, olanzapine, haloperidol, promethazine

Question 17

if patient is cooperative during acute agitation

Answer 17

PO Lorazepam, PO risperidone

Question 18

NMS symptoms (antipsychotics)

Answer 18

muscle rigidity, fever, autonomic dysfunction, altered consciousness, increased serum creatine kinase

Question 19

ortho hypot: which drug has the lowest risk

Answer 19

aripripazole

Question 20

ortho hypo t: does olan or quet have higher risk?

Answer 20

quet

Question 21

ortho hypo t: does risp or pali have higher risk?

Answer 21

risp,pali, quet same

Question 22

ortho hypo t: does cloz or risp have higher risk?

Answer 22

cloz

Question 23

ortho hypot: which drug has the highest risk

Answer 23

chlorpromazine

Question 24

what drugs have risk of vte

Answer 24

low potency fga

Question 25

qtc prolong: which drug has higher risk (olan/quet)

Answer 25

quet. olan has the lowest risk

Question 26

qtc prolong: which drug has higher risk (halo/cpz)

Answer 26

cpz

Question 27

qtc prolong: which drug has higher risk (quet/risp)

Answer 27

quet

Question 28

qtc prolong: which drug has the highest risk

Answer 28

thioridazine

Question 29

drugs causing neuroleptic malignant syndrome

Answer 29

high potency antipsychotics

Question 30

antidote for nms

Answer 30

IV dantrolene, PO dopamine agonist

Question 31

clozapine adverse effects

Answer 31

decrease in wbc count, agranulocytosis (blood dyscrasias)

Question 32

what to monitor

Answer 32

BMI, fasting sugar, lipids, blood pressure, EPSE exam

Question 33

elderly what to avoid

Answer 33

drugs causing alpha1 adrenergic blockade, anticholinergic side effects

Question 34

2d6 inhibitors

Answer 34

fluoxetine, paroxetine, bupropion

Question 35

3a4 inducers

Answer 35

simvastatin, lovastatin, nifedipine, amlodipine, diltiazem, phenytoin, cbz

Question 36

fluvoxamine pd characteristics

Answer 36

1a2 inhibitor, 2c19 inhibitor

Question 37

substrates of 2d6

Answer 37

metoprolol, codeine, hydrocodone, oxycodone, tramadol

Question 38

substrates of 1a2

Answer 38

amiodarone, theophylline, warfarin

Question 39

clozapine interactions

Answer 39

(1a2 inhibitors) fluvox, quionlones, macrolides, isoniaid, ketoconazole (agranulocytosis) cbz

Question 40

contraindication to antipsych

Answer 40

qtc prolongation

Question 41

precautions of antipsychs

Answer 41

cvs parkinson's disease prostatic hypertrophy angle closure glaucoma

Question 42

what to avoid with IM olanzapine

Answer 42

use of IM lorazepam

Question 43

low potency antipsychs

Answer 43

clozapine, chlorpromazine, quetiapine

Question 44

high potency antipsychs

Answer 44

haloperidol, olanzapine, risperidone

Question 45

side effects of antipsychs

Answer 45

dystonia, pseudo-parkinsonism, akathisia (restlessness), tardive dyskinesia, hyperprolactinemia, metabolic orthostatic hypoT NMS (muscle rigidity, fever)

Question 46

monitoring for sga

Answer 46

bmi, fasting blood glucose, lipid panel, blood pressure, epse exam

Question 47

to reverse epse effects

Answer 47

IM benztropine (antichol)

Question 48

to mitigate akathisia (restlessness)

Answer 48

clonazepam, propanolol

Question 49

to reverse tardive dyskinesia

Answer 49

discontinue anticholinergics

Question 50

drugs should be given IM or IV

Answer 50

IM, prevent bp crashing

Question 51

sedation higher (cpz/cloz)

Answer 51

cpz. it has the highest risk of sedation.

Question 52

sedation (risp/cloz)

Answer 52

cloz

Question 53

sedation (risp/olan)

Answer 53

olan

Question 54

sedation (quet/cloz)

Answer 54

cloz

Question 55

sedation (quet/risp)

Answer 55

quet

Question 56

sedation (pali/quet)

Answer 56

quet

Question 57

seizure (cloz/sga/cpz)

Answer 57

cloz/cpz > sga

Question 58

which drugs cause raised lfts

Answer 58

cpz and other fga, olan, quet

Question 59

haloperidol/olanzapine a substrate of?

Answer 59

1a2, 2d6

Question 60

risp a substrate of ?

Answer 60

2d6, 3a4

Question 61

quetiapine a substrate of?

Answer 61

3a4

Question 62

aripiprazole a substrate of?

Answer 62

2d6, 3a4

Question 63

clozapine a substrate of?

Answer 63

1a2

Question 64

side effect of blockage of post synaptic receptor

Answer 64

epse