Cns

Front 1

LIst 4 long half-life (25-100 hours) Benzos.

Back 1

1. Librium (chlordiazepoxide)
2. Klonopin (Clonazepam)
3. Valium (diazepam)
4. dalmane (Flurazepam)

Front 2

List 3 medium (10-15 hours) benzodiazepines.

Back 2

1. Ativan (Lorazepam)
2. Restoril (Temazepam)
3. ProSom (estazolam)

Front 3

List 2 short half-life Benzodiazepines (<12 hours)

Back 3

1. Xanax (aplrazolam)
2. Serax (Oxazepam)

Front 4

strong 3A4 inhibitors

KFI-VD-EC

EC

Erthromycin
Clarithromycin

Back 4

KFI VD EC

1. Ketoconazole
2. Fluconazole
3. itraconazole
4. Verapamil
5. Diltiazem

Front 5

What is the BuSpar?

Back 5

MOA unknown, more close to 5HT1A receptors

Max: 60 mg/d
start 15 mg/day increase by 5 mg

Front 6

what is the indication of BuSpAR?

Back 6

Buspirone (BuSpar)

--> anxiety

Front 7

What is the indication of Luvox?

Back 7

Fluvoxamine

--> OCD

Front 8

5HT1-->

5HT2-->

5HT3-->

Back 8

5HT1--> depression

5HT2--> sexual dysfunction

5HT3--> GI side effects

Front 9

"SSRI and NSAIDs"
One thing in common....

Back 9

cause GI bleeding (severe)

-less seen in Luvox and celexa

Front 10

Which SSRI is...

1) sedating..
2) activating..

Back 10

1) Luvox
2) Prozac

Front 11

Luvox

2D6 or 1A2 inhibitors?

Back 11

1A2 inhibitor

Front 12

Paxil, Prozac

3A4 or 2D6?

Back 12

2D6

Front 13

Pristiq

max: 400 mg/day; 50 mg

Back 13

desvenlafaxine

Front 14

Depression med can increase blood pressure

Back 14

1. Effexor (venlafaxine)
2. Cymbalta (duloxetine)

Front 15

what is milnacipran?

Back 15

Savella
- SNRI
- only approved for fibromyalgia
- can increase BP and heart rate

Front 16

wellbutrin

sedating or activating?

Back 16

activating; take 2nd dose before 5 pm

Front 17

which med can cause priapism?

(it's prolong, painful erection- rare but it's medical emergency)

Back 17

trazodone

Front 18

serzone (Nefrazodone)

Back 18

sister of Trazodone

Front 19

remeron (mirtazapine)

sedating or activating?

Back 19

sedating, best taken at bedtime

Front 20

Marplan

Back 20

Isocarboxazid

Front 21

Nardil

Back 21

Phenelzine

(MAO inhibitor)

Front 22

Parnate

Back 22

Tranylcypromine

(MAO inhibitor)

Front 23

Emsam

Back 23

selegiline (MAO inhibitor Type B)

Front 24

2 BBW of Valproic acid

Back 24

1. Hepatic failure
2. life threatening pancreatitis

Front 25

Stavzor

Back 25

Valproic acid EC

Front 26

BBW of carbamazepine

Back 26

aplastic anemia, agranucytosis

Front 27

BBW of Lamotrigine (Lamictal)

Back 27

Rash

Front 28

Lithium can increase....

Back 28

WBC production in the bone marrow

Front 29

what is optimal Li+ level?

Back 29

0.8-1.2 mmol/L

Front 30

Li+ + NASIDS --> ?

Back 30

reduce the kidney's ability to eliminate Li+ and lead to elevated levels of Li+ in the blood

Front 31

Aspirin and which NASID do not appear to affect Li+ level?

Back 31

sulindac (clinoril)

Front 32

ACEi, diuretics + Li+ ----> ?

Back 32

increased Li+ level in the blood

Front 33

Medications which cause the urine to become alkaline (the opposite of acidic) can

1) decrease, or

2) increase

the lithium level in the blood

Back 33

Decrease lithium

Front 34

what are Lithium early side effects?

Back 34

1. GI symptoms (the earliest)
2. fine tremor
3. Thirst and polyuria

Front 35

What are Lithium late side effects?

Back 35

1. Nephrogenic (diabetic insipidus like syndrome)
2. Leukocytosis
3. Hypothyroidism (constipation)
4. weight gain
5. acne
6. bradycardia

Front 36

What is the antidote for Lithium toxicity?

Back 36

no antidote, supportive care

Front 37

4 positive symptoms of Schizophrenia?

Back 37

1. hallucinations
2. deusions
3. disorganized behavior
4. disorganized

Front 38

Side effects of antipsychotic drugs?

"WASH MEN"

Back 38

WASH MEN

1. Weight gain
2. Anticholinergic
3. Sedating
4. Hypotension

5. Movement disorder
6. EPSE
7. NMS (Neuroleptic malignant syndrome)

Front 39

What are cholinergic effects?

"SLUDGE"

Back 39

S: salivation
L: Lacrimation
U: Urination
D: Defecation
G: GI motility
E: Excretion

Front 40

How many types of EPSE? difference? and treatment?

Back 40

EPSE: due to dopamine agonist activity

1. Dystonia (hours-days); painful muscle spasm (Tx: IV Benadryl)

2. Akathisis (days-weeks) restlessness; propranolol 30-100 mg QD

3. Pseudoparkinsonism (weeeks-months)

Front 41

Tardive dyskinesia (TD) v.s. Neuroleptic malignant syndrome (NMS)

Back 41

TD: due to prolonged blockage of dopamine

NMS: due to depletion of DA in the CNS --> life threatening

Front 42

Tx for NMS (neuroleptic malignant syndrome)?

Back 42

1. DA agonist: Bromocriptine
2. Dantrolene (muscle relaxant) 1 mg/kg rapid IV push

Front 43

What typical/atypical drugs are available in IM form? That can be used when "rapid tranquilization"needed.

Back 43

1. Haldo
2. Ziprasidone
3. Geodon
4. Abilify

Front 44

What typical/atypical drugs are available in decanoate form? That can be used for patients with good response to oral but noncompliance

Back 44

1. Haldol (Q month)

2. Prolixin (Fluphenazine) Q 2 weeks
3. Risperdal Consta Q 2 weeks
--> Give PO for 3 weeks and then D/C oral; need to be > 18 years

Front 45

What is cut-off # WBC before we can fill Clozapine? Why?

Check CBC Q week for 6 months
then Q 2 weeks for another 6 months, and
then once monthly

Back 45

WBC > 3500/mm3, because of agrnulocytosis (fever, sore throat, easy brusing)

Front 46

List 6 side effects of Clozapine

Back 46

1. Agranulocytosis
2. seizure
3. hyperlipidemia
4. hyperglycemia
5. most weight gain
6. hypersalivation and sweating

Front 47

Risperdal (Risperidone) are available in what forms?

Back 47

1. tablet
2. disintegrating tablet
3. solution
4. IM injection

Front 48

what are the 2 major side effects of Risperdal?

Back 48

1. the most EPS
2. Increased prolactin level

Front 49

Geodon

1. dosing frequency? max dose?
2. how do you take Geodon?
3. Least problem? the most problem?

Back 49

1. 20 mg BID with food
2. max: 80mg/day
3. weight gain; QT prolongation

Front 50

Invega

Back 50

Paliperidone (active metabolite)
3-12 mg QD

OROS

Front 51

Lithium citrate (Lithium syruup)

8 meq/5 ml = ? mg

Back 51

300 mg

Front 52

Acute levels of Lithium?

Back 52

0.8-1.5 meq/L

Front 53

Maintenance level of Lithium?

Back 53

0.6-1.2 meq/L

Front 54

List AE of lithium

Back 54

1. GI (N/V/D)
2. fine intentional tremor
3. Polyuria/polydipsia
4. nephrogenic diabetic insipidus like syndrome
5. leukocytosis
6. hypothyroidism (constipation)
7. weight gain
8. acne
9. bradycardia

Front 55

2 conditions would decrease Lithium level

Back 55

1. pregnancy
2. NaCl

Front 56

List 3 drugs and 3 conditions can increase Lithium levels

Back 56

1. ACE i
2. HCTZ
3. NSAIDs

4. Na restrictions
5. dehydration
6. renal impairment

Front 57

What is the basic pathophysiology behind Parkinson's disease?

Back 57

1. imbalance between dopamine and Acetylcholine

2. More Ach than dopamine

Front 58

BBW of Reglan?

Back 58

1. EPS in < 30 years old

2. Tardive dyskinesia

Front 59

Parkinson's disease is due to lack of dopamine. What are the treatment choices?

Back 59

1. Dopamine agoinsts
2. Dopamine precursors
3. Dopamine reuptake inhibitors
4. MAO and COMT inhibitors
5. Anticholnergic drugs

Front 60

Class of artane?
Indication?

Back 60

Anticholinergic; Parkinson's disease

Front 61

Class of cogentin? indications?

Back 61

Anticholinergic; Parkinson's disease

Front 62

What are the cautions/contraindications of anticholinergic drugs?

Back 62

1. BPH
2. Narrow-angle glaucoma
3. Bladder neck obstructions
4. Myasthenia gravis

Front 63

No movement, need movement. What do you do?

Back 63

No movement b/c lack of Ach. Increase Ach--> give Ach esterase

Front 64

What is sinemet?
(Carbidopa + levodopa)

Back 64

Levodopa--> precursors of dopamine

Carbidopa -->
1. allow move Levodopa cross BBB;
2. need at least 75 mg to blockdopa decarboxylase inhibitors

Front 65

Sinemet v.s. Sinemet CR?

Back 65

Sinemet: TID or QID
Sinemet CR: BID (at least 6 hours apart); less Bioavilable (need highrt dose)

Front 66

dietary proteins + sinemet -->

Back 66

Dietary proteins will compete the levodopa absorption in the intestines. reduced the effectiveness of Levodopa.

Take proteins at different time

Front 67

Eldepryl

Back 67

Selegiline

5 mg cap QAM and QNoon (BID);
max: 10 mg/day

Front 68

Zelapar

Back 68

Selegiline

1.25 mg orally disintegrating tabs 1 QD

Front 69

Emsam

Back 69

Selegiline

for major depressive disorder

Front 70

Selegiline + SSRIs -->

Back 70

serotonin syndrome
(high BP, tremor, high fever, diaphoresis)

Front 71

isocarboxazid

Back 71

Marplan

Front 72

Parnate

Back 72

tanylcypromine

Front 73

Nardil

Back 73

phenelzine

Front 74

Symmetrel
--> increase dopamine release
--> exerts anticholinergic effects

Back 74

Amantidine
- for Parkinson's disease and influenza A
- 100% renally excreted

Front 75

Apomorphine

Back 75

Apokyn
-SC injection
- dopamine agonist

Front 76

Parlodel
1) generic name
2) indications

Back 76

1) Bromocriptine
-- >dopamine agonist
2) hyperprolactinemia (increase milk production)

Front 77

Permax?
1) generic name?
2) Titrate slowly to avoid....

Back 77

1) Pergolide (dopamine agonists)
2) hypotension

Front 78

Examples of dopamine antagonists drugs

Back 78

1. Reglan
2. neuroleptics (phenothiazines)

Front 79

Apomorphine (Apokyn) + 5HT3 (zofran) --> CI; why?

Back 79

Profound hypotension and loss of consciousness

Front 80

Class of drugs..

1) entacapone (comtan)
2) Tolcapone (Tasmar)

Back 80

COMT inhibitors

Front 81

What is BBW of Tasmar?

Back 81

Tolcapone
-- Fatal hepatic failure

Front 82

Stalevo

Back 82

Sinemet + entacapone