Week 11

Question 1

SSRI plus partial antagonist of 5-HT1A receptor:

Answer 1

Viibryd

Question 2

Examples of SNRIs:

Answer 2

Effexor (venlafaxine)
Cymbalta (duloxetine)
Savella (milnacipran)

Question 3

What SNRI is also used for hot flashes, menopause in women who cannot take hormones?

Answer 3

Effexor(venlafaxine)

Question 4

Example of tricyclics:

Answer 4

Elavil (amitriptyline)

Question 5

Example if MAOI:

Answer 5

Nardil (phenelzine)

Question 6

Examples of serotonin receptors antagonists:

Answer 6

Remeron (mirtazapine)

Oleptro (trazadone)

Question 7

Wellbutrin is an:

Answer 7

Aminoketone

Question 8

Abilify (aripiprazole) is an:

Answer 8

Atypical antipsychotic that can be used for refractory depression or bipolar depression.

Question 9

SSRIs MOA:

Answer 9

Potently and selectively inhibit serotonin uptake on presynaptic neuron which increases concentration of 5HT in synapse by inhibiting reuptake.

Question 10

SSRIs are indicated for:

Answer 10

Frequently 1st choice for depression
Used with anxiety
Very useful in OCD

Question 11

Examples of SSRIs:

Answer 11

Zoloft (sertraline)
Paxil (paroxetine)
Celexa (citalopram)
Lexapro (escitalopram)
Luvox (fluvoxamine)
Prozac (fluoxetine)-oldest with longest half-life

Question 12

What SSRI do you not need to taper off?

Answer 12

Prozac due to long half-life

Question 13

SSRI with shortest half-life?

Answer 13

Luvox (fluvoxamine)

Question 14

How long for SSRI to reach full therapeutic strength?

Answer 14

2 weeks

Question 15

Side effects of SSRIs:

Answer 15

Nausea, loose stools
Sexual dysfunction
Weight gain
Black box: suicidal ideation

Question 16

Symptoms of serotonin syndrome:

Answer 16

Rigidity
Hyperthermia
Autonomic instability
Tremors
Confusion
Delirium
Coma

Question 17

Causes of serotonin syndrome:

Answer 17

Interaction of SSRI with cardiac meds
Dosage too high
Interaction with MAOIs
Interaction with St. John’s Wart

Question 18

SSRI withdrawal syndrome symptoms:

Answer 18

Flu-like
Lightheadedness 
Uneasiness or restlessness 
Sleepiness or sensory disturbances
Headaches

Question 19

Short acting benzodiazepines:

Answer 19

Ativan, Xanax, Serax

Question 20

Long acting benzodiazepines:

Answer 20

Klonopin

Librium

Question 21

Longest half life of the benzodiazepines:

Answer 21

Valium

Question 22

MOA of benzodiazepines:

Answer 22

Bind to molecular components of GABA receptors in the CNS’s neuronal membranes. Potential GABA-ergic inhibition at all levels of CNS which decreases the firing rate of critical neurons

Question 23

Benzodiazepines metabolized in:

Answer 23

Liver

Question 24

Side effects of benzodiazepines:

Answer 24

Sedation
Respiratory depression
Increased tolerance/physiologic dependence

Question 25

Benzodiazepine antagonist:

Answer 25

Romazicon delivered IV

Question 26

Serotonergic Agonist:

Answer 26

Buspirone (Buspar)

Question 27

Buspirone is used in treatment of:

Answer 27

Anxiety (no effect of GABA system so do not use in benzodiazepine withdrawal)

Question 28

Side effects of buspirone:

Answer 28

``` Dry mouth Lightheadedness Headache Insomnia Interaction with maois or SSRIs May potentiate serotonin syndrome ```

Question 29

ADHD diagnostic criteria:

Answer 29

``` Consistent through time More than one setting Existed before 12 Clear impairment of functioning No longer disqualified by comorbid diagnosis ```

Question 30

First line treatment of adhd:

Answer 30

Stimulants: adderral(amphetamine/dexamphetamine) or Ritalin (methylphenidate)

Question 31

Contraindications of stimulants:

Answer 31

History of schizophrenia or other psychosis | Symptoms of anxiety, tension, and agitation

Question 32

Side effects of stimulants:

Answer 32

``` Decreased appetite Delayed onset of sleep Rare: Growth deceleration Blood dyscrasias (CBC once/twice a year) Mood changes Hallucinations ```

Question 33

First line nonstimulant medication for adhd:

Answer 33

Strattera (atomoxetine)

Question 34

Strattera is a:

Answer 34

Noradrenergic reuptake inhibitor- increases norepinephrine

Question 35

Strattera is not to be used:

Answer 35

With glaucoma or MAOIs or concurrently with albuterol

Question 36

Side effects of strattera:

Answer 36

``` Suicidal ideation Liver damage Effect not always immediate GI upset Decreased appetite Mood swings BP increase ```

Question 37

Clonidine is an:

Answer 37

Alpha-2 agonist- good mood stabilizer, capable of controlling tics and hyperactivity

Question 38

Side effects of clonidine:

Answer 38

Hypotension Dry mouth Oversedation Rebound hypertension is stopped abruptly

Question 39

Guanfacine is an:

Answer 39

Alpha-2 agonist that is less sedation than clonidine and the only antihypertensive agent approved for ADHD

Question 40

What antidepressants are food for patients with somnolence?

Answer 40

Fluoxetine (Prozac) and sertraline (Zoloft)

Question 41

What antidepressant is good for patients with insomnia:

Answer 41

Paroxetine(Paxil)

Question 42

Second line therapy in depression:

Answer 42

TCA- nortriptyline or desipramine

Question 43

First line therapy for GAD:

Answer 43

SSRI or SNRI

Question 44

Second line for GAD:

Answer 44

Buspirone or imipramine