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Psych 2016 > UWorld Drugs > Flashcards

UWorld Drugs Flashcards

1
Q

What med class give for:
Woman wandering streets, disheveled, malodorous, malnourished. Smiles pleasantly, difficult to hold her attention.
She stares at A/C unit and said “jingle jangle, doctor, jingle jangle.”
Urine tox and blood alcohol level negative.
She agrees to admission to psych unit.

A

Psychosis:
- give 2nd generation antipsychotic

Risperidone / Ziprasidone
Aripiprazole
Quietiapine / Olanzapine

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2
Q

Clozapine can be used to treat psychosis. Why is it not a 1st line agent? When use?

A

Clozapine: 2nd gen antipsychotic

- SE = agranulocytosis

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3
Q

What med give for treatment-resistant schizophrenia?

A

Clozapine

- use when pt failed at least 2 trials of antipsychotics

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4
Q

What class of meds is discouraged in elderly due to risk of adverse effects? What kind of adverse effect?

A

Benzodiazepines
SE: paradoxical agitation (usually w/in one hour of administration). Confusion + falls.

Alprazolam

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5
Q

What is paradoxical agitation? What drug class?

A

Increased agitation, confusion, aggression, disinhibition

Benzodiazepines: elderly metabolize it more slowly.

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6
Q

If give risperidone for schizophrenia, what two sexual side effects from DECREASED dopamine in ______ area of brain?

A

Tuberoinfundibular pathway

  • decreased dopamine = increased prolactin = breast enlargement (gynecomastia, galactorrhea)
  • decreased libido
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7
Q

Pt very sleepy
Hears voices when falling asleep
Feels temporarily frozen, unable to move on awakening

How treat including Med to give?

A

Narcolepsy
(cataplexy = emotionally triggered loss of muscle tone)

Sleep hygiene
Scheduled naps
Modafinil: promotes wakefulness = 1st line

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8
Q

78yo problem sleeping past few months. Wife died 1 year ago. Takes 45-60 minutes to fall asleep. Frequent waking during night. Wakes at 430am and can’t return to sleep.
Mild forgetfulness; appetite not what it once was. Weight loss past 6 months.
No longer golfs as tired and no longer enjoys.

A

Think major depressive disorder more than just a sleep disorder.

Treat w/ antidepressants + cognitive-behavioral therapy

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9
Q 
Frantic effort avoid abandonment
Unstable & intense relationships
Unstable self-image
Impulsivity (possible Suicide attempt)
Feeling empty, intense anger
1st Line treatment? Dx?
A

Borderline personality disorder

1st line = psychotherapy
dialectical behavioral therapy

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10
Q

Molly, aka?, main drug class?

A

Ecstasy

- amphetamine

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11
Q

Hypertension
Tachycardia
Hyperthermia
Serotonin syndrome with what drug?

A

MDMA = Molly = Ecstasy

  • autonomic dysregulation
  • altered mental status
  • seizures
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12
Q

What make you suspect delirium?

- how test?

A

Acute confusion + chronic memory impairment
- after surgery or other stressor

Get EEG: see diffuse slowing

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13
Q

Failed SSRI (fluoxetine) with continues depression. What next to try?

A

SNRI - venlafaxine

could augment, switch to another SSRI or switch class of antidepressant, as above

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14
Q

Brief euphoria + loss of consciousness

Class of drug?

A

Inhalants

  • glue, toluene
  • Nitrous oxide, amyl nitrate
  • spray paint

Boys age 14-17

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15
Q

1st Line Bipolar?

Two others you could use?

A

Lithium + 2nd gen antipsychotic
(quietiapine, lurasidone)

Other high yield: valproate, lamotrigine

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16
Q

2nd Generation Antipsychotic mech of action?

- risperidone

A

Serotonin-dopamine antagonist
- serotonin 2A
- dopamine D2
…receptor blockade

17
Q

Haloperidol can produce ____ a subset of EPS (extrapyramidal symptom).

A

Acute dystonic reaction
- sustained contraction of neck, mouth, tongue, eye

Often seen w/ high-potency first generation antipsychotics

18
Q

How treat acute dystonic reaction?

A

Benztropine

Diphenhydramine

19
Q

Everyone knows _____ can cause agranulocytosis. What other adverse effects are possible?

A

Clozapine

  • metabolic syndrome
  • seizures
  • myocarditis
20
Q

Chlorpromazine is?

A

Low potency, first-generation antipsychotic

21
Q

What meds avoid in bipolar I and why?

A

Avoid antidepressant mono therapy

- risk of precipitating mania

22
Q

Contraindications to Bupropion?

A

Bupropion = Ne + D reuptake inhibitor

  • can’t use in pt w/ seizures
  • can’t use in pt w/ eating disorders
23
Q

Amantadine

A

Dopaminergic agonist, treat:

  • parkinsonism: bradykinesia
    • cogwheel rigidity
    • pill-rolling tremor
    • masked facies
    • shuffling gait
24
Q

Alprazolam

A

Short-acting BDZ

  • seizure, tremor, anxiety after cessation
  • perceptual disturbances, psychosis after cessation
25
Q

Phenelzine + dinner with heavy sauces and wine, what exam finding expected?

A

Hypertensive crisis: MAOI + tyramine

  • increases release of adrenaline b/c…
  • tyramine metabolism inhibited by MAOI
26
Q

Headache is early sign of hypertensive crisis.

What are 3 other signs?

A

Intracranial bleed
Stroke
Death

Psych 2016 (14 decks)

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