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Cards In This Set
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Methylphenidate (Ritalin) is indicated for the tx of
a) ADHD
b) insomnia
c) obesity
d) opioid overdose
e) schizophrenia
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A) ADHD
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A pt referred to your clinic is taking Prozac (fluoxetine). You should know that this drug is a/an
a) antimanic
b) antidepressant
c) MOA-B inhibitor
d) neuroleptic
e) hypnotic
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B) antidepressant
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Lithium toxicity has occurred in pts stabilized on lithium carbonate therapy when which of the following drugs is added to the regimen?
a) thiazide diuretic (eg. hydrochlorothiazide/HydroDiuril)
b) Macrolide antibiotics (eg. erythromycin)
c) anticonvulsant therapy (eg. phenytoin/Dilantin)
d) anticholesterol drugs (eg. cholestyramine/Questran)
e) sympatholytics (eg. doxazin/Minipress)
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A) thiazide diuretic (eg. hydrochlorothiazide/HydroDiuril)
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The antipsychotic drugs (eg. phenothiazines, thioxanthines, butyrophenones) may cause Parkinson-like symptoms (extrapyramidal symptoms) by blockade of dopamine receptors in the
a) striatum (basal ganglia)
b) cerebellum
c) chemoreceptor trigger zone
d) frontal lobe
e) hypothalamus
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A) striatum (basal ganglia)
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Which of the following statements about antidepressants is FALSE?
a) Many of these drugs are relatively potent anticholergic effects.
b) The popular Prozac has a half-life measured in days.
c) Prozac has been reported to increase toxicity of a number of drugs (eg. tricyclics)
d) Fatal hyperpyrexia has been reported when meperidine (Demerol) has been administered to pts on MOA inhibitor drugs (eg. tranylcypromine/Parnate)
e) Controlled studies show the selective SSRIs produce markedly superior results over the older tricyclic antidepressants.
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E) Controlled studies show the selective SSRIs produce markedly superior results over the older tricyclic antidepressants.
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A pt has been taking relatively high doses of Valium for years. You can expect all of the following EXCEPT
a) anxiety, insomnia, and restlessness within 12-24 hrs of abrupt withdrawl of Valium
b) increased sedative effect on administration of opioids.
c) reduced dosage requirements for thiopental or halothane.
d) some degree of tolerance on administration of other benzodiazepines.
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A) anxiety, insomnia, and restlessness within 12-24 hrs of abrupt withdrawl of Valium
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Most antipsychotic drugs seem to act by
a) blocking postsynaptic D2 receptors.
b) potientiating GABA
c) binding to the COX2 receptors
d) blocking sodium channels
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A) blocking postsynaptic D2 receptors.
However, atypical drugs are weak D2 blockers and usually affect 5HT receptors.
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Conventional drugs do better with
a) positive symptoms
b) negative symptoms
c) both
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A) positive symptoms
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Atypical drugs do better with
a) positive symptoms
b) negative symptoms
c) both
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C) both
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ANTIPSYCHOTICS
Match DON"T or DO
a) alleviate N/V
b) cause dependence
c) cause addiction
d) have a major effect on the heart
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A) DO alleviate N/V
b) DON'T cause dependence
c) DON'T cause addiction
d) DON'T have a major effect on the heart
They also have a large therapeutic index> may be more sleepy with a larger dose.
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Antipsychotics mostly work in which part of the brain?
a) Basal ganglia
b) Hypothalamus
c) Brainstem
d) Limbic system (mesolimbic and meso frontal systems)
e) Chemoreceptor trigger zone
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D) Limbic system (mesolimbic and meso frontal systems)
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Antipsychotics
T/F
a) most antipsychotics lower sz threshold
b) The limbic system paticipates in the regulation of feeding behavior, the sleep-wake cycle , emotions, and behavior.
c) Most neuroleptic agents have a destructive effect against N/V-inducing effects of apomorphine.
d) These drugs stimulate cholinergic activity causing runny nose & hyper-secretions.
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A) T
b) T
c) F
d) F
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Matching
a) Conventional agents
b) Atypical agents
1) have increased affinity for 5-HT2 receptors but act on other receptors. THey are noted for decreased ability to cause EPS.
2) are dopamine receptor antagonist with a higher affinity for non-dopaminergic sites. They are likely to cause EPS.
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1) B
2) A
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What is the principle difference btwn conventional antipsychotics and atypical?
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Severity of SE which include antihistaminic (sedation), antiserotonergic (weight gain), antidopamine D2 (EPS, prolactin release), anticholinergic (Dry mouth) and anti a1 (orthostatic hypotension).
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SE of antipsychotics are:
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Typically none unless given IV; some cause QT interval. If you give one that prolongs the QT interval need to check all other drugs to make sure they do not prolong the QT interval, otherwise may cause torsade de pointes & sometimes death.
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