Pharm 2 Exam #1

Front 1

Sedatives cause.....

Also considered ____ agents

Not intended for the use for....

Back 1

Calmness and relaxations;

anxiolytic/antianxiety;

the stress and tension of every day living

Front 2

Hypnotics produce _____ therefore it is automatically a ____ Agent.

Back 2

sleep; sedative

Front 3

What are the 4 stages of sleep?

Back 3

0=awake; 1= onset of sleep; 2= slight sleep; 4= REM sleep

Front 4

How much time is spent in light sleep/stage 2?

Back 4

50%

Front 5

How much time is spent in REM sleep?

Back 5

25%

Front 6

Most all drugs in the sedative-hypnotic class of drugs can cause....

Back 6

physical and psychological dependence

Front 7

Barbiturate sedative/hypnotics are induces of _______ which can cause.......

Back 7

P450 system;

numerous drug interactions

Front 8

Barbiturate sedatives-hypnotics are _____ depressants.

Low doses are _____, higher doses are ______ and highest doses are ______.

No longer considered appropriate for treatment of _____ or ______.

Have a ______ therapeutic index

All barbiturates exhibit _______ activity.

Back 8

CNS;

sedative; hypnotic; anesthetic;

anxiety or insomnia;

low/narrow;

anticonvulsant

Front 9

What is an ADR of large doses of barbiturates?

Back 9

prolonged CNS depression

Front 10

Chronic use of barbiturates can cause ____, ____ and risk of _____.

Back 10

tolerance, dependence, withdrawal syndrome

Front 11

What are the two components of tolerance?

Back 11

enzyme induction; adaptive CNS changes

Front 12

Barbiturates have a very high potential for ______ and ______ which can occur in as little as ___________

_______ syndrome can be experience and can be severe/fatal. Sx include ____ and _____

Back 12

physical and psych dependence; 1-3 months;

Abstinence; convulsions and delirium

Front 13

Abstinence syndrome is associated with which class of drugs?

Back 13

Barbiturate sedative/hypnotics

Front 14

An overdose of barbiturates results in depression of the _____ and ____ control centers in the brain resulting in......

Back 14

medullary respiratory and CV control centers; fatality due to respiratory failure

Front 15

Barbiturates have an additive/synergistic CNS depression when mixed with....

Back 15

other depressants including alcohol

Front 16

Estazolam, Triazolam and Flurazepam are all drugs of the __________ class

Back 16

benzodiazepine hypnotic

Front 17

Benzodiazepine Hypnotic agents are indicated for ______ characterized by _____, _______ or _______

Back 17

insomnia; difficulty in falling asleep, frequent nocturnal awakening, or early morning awakening

Front 18

Benzo Hypnotics work by....

Back 18

potentiating (increasing) transmission involving pathways using GABA as an inhibitory NT

Front 19

There are two subtypes of the GABA-A receptor: BZ1 and BZ2.
BZ1 receptor stimulation results in ______ and ______

Back 19

sleep onset and cycle regulation

Front 20

All GABA-A BZ1 receptors become activated nonspecifically by ______ which accounts for......

Back 20

benzos; the wide range of a cation of BZs (sedation, hypnosis, anti anxiety, anticonvulsant, muscle relaxant)

Front 21

Which three benzo drugs can activate only one of the BZ binding sites?

This may account for their relatively selective ______ action and lack of ____ and _____ effects.

Back 21

zolpidem, zalepon, eszopiclone;

hypnotic; anticonvulsant; muscle relaxant

Front 22

Barbiturates bind to specific receptors that are _____ from BZ receptors which results in _____ CNS depressant activity compared to BZs

Have _____ activity at higher concentrations and inhibit .........

Back 22

distant; greater


GABAmimetic; excitatory CNS NTs (glutamate)

Front 23

What is the effect of BZs on sleep patterns?

Back 23

increase total sleep time

Front 24

BZs decrease time spent in sleep stage ___ and ____ and also decrease the number of ____ during the night.

They also increase stage _______.

BZs delay the onset of ____ and _____ is diminished.

BZ hypnotics are very successful initially but....

Back 24

0, 1; awakenings;

2;

REM; dreaming;

tolerance develops

Front 25

Short-Medium acting BZs are best to achieve ___ onset with duration lasting through the night but having no _____ the next day.

Back 25

rapid; 'hangover'

Front 26

Triazolam is a ____ acting BZ and is preferable in the _____ but may result in......

Back 26

short; elderly; early morning awakening

Front 27

Estazolam is a _____ acting BZ

Back 27

intermediate

Front 28

Flurazepam is a _____ acting BZ that has a long _________

Back 28

long; half-life

Front 29

Increased daytime anxiety after 10 days of continuous use was experience in pts taking _______ and this is thought to be due to......

Also experienced _____ which is considered to be a class effect of BZs

Back 29

Triazolam; development of tolerance and 'interdose withdrawal'

anterograde amnesia

Front 30

Pts can develop _______ while taking BZs and withdrawal symptoms following abrupt d/c can occur including ____, _____ or _____ if severe.

Back 30

physical dependence;

muscle cramps, tremors, convulsions

Front 31

Rebound insomnia can occur in pts taking BZs when the drug is ______. Duration of sleep and quality also becomes ________ than before treatment.

May occur after abrupt d/c of _____ but is less likely to occur in _____ agents.

Back 31

withdrawn; worse; triazolam;
longer-acting agents

Front 32

BZs have additive/synergistic effects with other _________

Back 32

CNS depressants

Front 33

Zolpidem and Zaleplon are _______ Drugs used in the short term treatment of ______ and is generally limited to ___-___ days.

Back 33

nonbarb/nonbz sed/hypnotic; insomnia; 7-10

Front 34

Zolpidem ER, eszopiclone, ramelteon are ______ Drugs indicated for the treatment of ________

Back 34

nonbarb/nonbz sed/hypnotic; insomnia

Front 35

Chloral hydrate is a ______ drug that is rapidly absorbed and metabolized to _________ (active metabolite)

_____, ____ and ____ may develop after several weeks of continued administration. Sudden withdrawal may cause ____, ____ and ______

Back 35

nonbarb/nonbz sed/hypnotic; trichloroethanol;

tolerance, physical, psych dependence; seizures, hallucinations, delirium;

Front 36

Chloral Hydrate has synergistic effects with ____ because they ___________ each other's metabolism and both have CNS _____ effects

Also have additive/synergistic effects with other CNS ______

Back 36

alcohol; competitively inhibit; depressant;

depressants

Front 37

Zolpidem is a ______ Drug that is a BZ receptor _____ which preferentially interacts with the ____ subtype.

Exerts ____ effects at doses which have no anxiolytic, anticonvulsant, or muscle relaxant effects

Also decreases stage ___ of the sleep cycle, increases _______ and _______

Back 37

nonbarb/nonbz sed/hypnotic; agonist; BZ1;

hypnotic;

1; total sleep time; sleep duration

Front 38

Zolpidem therapy is limited to ____-____ days.

Potential for dependence, tolerance or rebound insomnia upon d/c appears ______

Does additive/synergistic interactions with other CNS _______

Back 38

7-10;

minimal;

depressants

Front 39

Zolpidem ER (Ambien) is the first and only ____ sleep medication that promotes _____ and _______ with no significant decrease in __________.

Not limited to _____ treatment.

Back 39

ER; falling asleep; maintaining sleep; next day performance;

short-term

Front 40

Zaleplon is a ____ receptor agonist.

Functions to shorten the time to _____ but does not significantly increase _____ or reduce the number of _____

Administer immediately at ___ or up to 4 hours prior to the ___________ when _______ occurs.

Can be dosed in the middle of the night without......

Has synergistic/additive CNS ______ effects.

Back 40

BZ1;

sleep onset; sleep duration; awakenings;

bedtime; anticipated; difficulty falling asleep;

residual sedation and next morning memory impairment;

depressants

Front 41

Eszopiclone is the active S-isomer of the hypnotic _____ which is a ____ receptor agonist.

Has a lower ____ and ____ potential and improved all components of ________

Less likely to cause residual ____ and ____ compared to BZs

Not limited to _____ use.

Back 41

zopiclone; BZ1;

dependence; abuse potential; insomnia;

daytime psychomotor and memory impairment;

short term

Front 42

Ramelteon is a _____________ drug and specifically stimulates _____ receptors which results in...

Indicated for use in adults for tx of ____ characterized by difficulty with _____. Not limited to _____ use.

No evidence of ___, ________, ____, or _____

Back 42

selective melatonin receptor agonist; MT1; sleepiness;

insomnia; sleep onset;short term;

abuse potential, dependence, rebound insomnia, withdrawal effects/next day residual effects

Front 43

BZ anxiolytics have what 5 shared pharm actions?

Back 43

hypnotic, anxiolytic, anticonvulsant, muscle relaxant, amnesiac

Front 44

What are the three advantages of BZ anxiolytics compared to other anxiolytics?

Back 44

rapid onset,high therapeutic index, relatively few ADR

Front 45

What are 3 disadvantages to BZ anxiolytics?

Back 45

tolerance, impaired psychomotor performance, dependence

Front 46

What is the first line of treatment for generalized anxiety disorder?

Second line?

When would BZs be used?

Back 46

antidepressants;

buspirone;

for acute relief or if sx warrant

Front 47

Stress related anxiety is.....

What is the DOC for reducing symptoms, especially insomnia and restlessness?

Back 47

anxiety that occurs as a result of a major life stressful event

BZs

Front 48

What is the DOC for panic disorder? What is important to tell pts when they begin these drugs?

What are the second line drugs? _______ is very effective quickly (within days)

Back 48

SSRIs; they will require 203 weeks for sx improvement;

BZs; alprazolam

Front 49

What are the DOC for treatment of PTSD?

Back 49

SSRIs

Front 50

Alcohol withdrawal syndrome symptoms can include ________, ___________ which occurs usually 48-72 hours after d/c, _____. _______. _____. _____ and _______

Back 50

tonic-clonic seizures, delirium tremens; hyperthermia, tachycardia, HTN, delirium, hallucinations

Front 51

What is the DOC for treatment for alcohol withdrawal syndrome?

Which two longer acting drugs are the best to use? This is because these drugs have active metabolites which _____ and provide _______ as the parent BZs are _____ resulting in fewer.......


Which two shorter acting drugs may be better to use in elderly pts or those with hepatic dz? This is because they do not undergo _________

Back 51

BZs;

chlordiazepoxide; diazepam; accumulate; continued activity; tapered; rebound effects/withdrawal seizures

lorazepam, oxazepam; hepatic metabolism

Front 52

Diazepam is indicated for use as a ____, _____ and _____

Back 52

muscle relaxant, anticonvulsant, preop medication

Front 53

Lorazepam is indicated as a ____ medication to produce ____ and ____. Can also be used in treatment of ______

Back 53

preanesthetic; sedation; amnesia;

status epilepticus

Front 54

Alprazolam is used for the treatment of ______ with or without _______

Back 54

panic disorder; agoraphobia

Front 55

Chlordizepoxide is used for the treatment of ________

Back 55

acute alcohol withdrawal syndrome

Front 56

All of the pharmacological effects of benzodiazepines are mediated through interactions with the _______ complex.

Back 56

GABA receptor;

Front 57

GABA-A Receptors are ____ channels that when activated by GABA they .......

This causes what to occur?

Back 57

ligand-gated;

open and allow chloride ion influx;

cell hyper polarizes which decreases/interrupts the synaptic and neuronal transmission

Front 58

The GABA-A receptor contains how many binding sites for BZs?

What do BZs act as?

Back 58

at least 3;

allosteric modulators of GABA activity

Front 59

When BZ binds to its receptor on the GABA-A receptor, the frequency of chloride channel opening is ______, GABA activity is _____ and the pharm actions of BZs are produced (_______, ______ and ______)

Back 59

increased; enhanced; hypnotic; anticonvulsant; muscle relaxant

Front 60

Potentiate means:

Back 60

facilitates

Front 61

BZs potentiate the effects of GABA (facilitates _________) by binding to the specific BZ receptor binding sites on the ___ subunit of the GABA receptor complex.

BZs are _____ of GABA and not GABA _______.

In the absence of GABA, BZs have.....

Back 61

inhibitory GABAergic neurotransmission;

alpha;

allosteric modulators; agonists;

no pharm actions

Front 62

In the spinal cord, BZs cause...

Back 62

muscle relaxation

Front 63

In the brain stem, BZs cause...

Back 63

anticonvulsant properties

Front 64

In the cerebellum, BZs cause....

Back 64

ataxia and sedation at doses beyond those needed for anxiolytic effects

Front 65

In the limbic and cortical areas, BZs cause....

Back 65

anxiolytic and amnesic effects

Front 66

BZs have a ____ margin of safety between the therapeutic and toxic doses.

Back 66

wide

Front 67

Which two BZs are absorbed poorly due to precipitation in muscle causing slow erratic absorption?

This causes peak levels to be _____ and take _____ to reach compared to oral dosing.

Back 67

Diazepam; chlordiazepoxide;

lower; longer;

Front 68

What is a common active metabolites of BZs, including diazepam?

This metabolite is formed via a ______ reaction. Accumulation of substance can occur in chronic dosing and cause....

Back 68

destheyldiazepam;

oxidation;

oversedation and ataxia

Front 69

Which two BZs are metabolized to inactive compounds and have a relatively short duration of action?

When may these be preferred for use?

Back 69

oxazepam; lorazepam;

in the elderly or those with hepatic disease

Front 70

BZs can have physical dependence with withdrawal symptoms occurring after several _____ of treatment.

What three factors favor withdrawal symptoms?

Back 70

weeks;

Use of short-ating agents, regular use for >3 month, abrupt d/c

Front 71

What are the characteristics of withdrawal syndrome associated with BZ dependence?

Back 71

muscle cramps, tremor, tonic-clonic seizures

Front 72

What are some expected ADRs associated with BZ use (due to high therapeutic index)?

Back 72

CNS depression (sedation, ataxia, lethargy, impaired psychomotor performance, depression)

Front 73

Overdoses of BZs have only a mild effect on _________ but may be fatal when taken with _____.

Back 73

respiration; alcohol

Front 74

BZs have additive/synergistic effects with other _______ causing severe ______

Back 74

CNS depressants; ataxia

Front 75

Buspirone is a ______ drug that is indicated for the management of ________ or short term relief of _____________

Back 75

non-BZ anxiolytic; anxiety disorders; symptoms of anxiety;

Front 76

The net effect of buspirone is to decrease _____ activity in states of ________.

Back 76

serotonergic; serotonin excess

Front 77

Buspirone is a ______ for serotonin at ____ receptors and an _______ in the presence of serotonin.

Is a full agonist at _________ receptors and _______'s serotonin release.

Back 77

partial agonist; postsyn; antagonist;

5HT1A presynaptic; inhibits

Front 78

Buspirone does not bind ______ receptors nor does it affect ______ transmission.

Has no ____ or ____ effects and lacks prominent _____ effects of other anxiolytics.

Does not exhibit cross-tolerance with ____ and ______.

Back 78

BZ; GABAergic;

anticonvulsant; msucle relaxant; sedative;

BZs and other sedatives/hypnotics

Front 79

Optimal results of buspirone use require ________.

No withdrawal syndrome or other significant ADR was reported upon abrupt d/c after _______

Back 79

3-4 weeks;

1 year of tx

Front 80

Buspirone ADR: affinity for ____ receptors might cause symptoms of blockade. These were NOT observed during clinical trials

Back 80

dopamine

Front 81

Concomitant administration of _________ is contraindicated when using Buspirone.

Back 81

MAOIs

Front 82

Inhibitors of ________ can cause elevation of busprione concentrations causing excessive _____ or _______

Back 82

CYP3A4 isozyme (P450); drowsiness or dizziness

Front 83

Flumazenil is a _______ drug.

Acts as a ______________.

Does not antagonize the effects of ____, _____ or ____ and does not reverse the actions of _____.

Back 83

BZ antagonist;

BZ receptor competitive antagonist;

ethanol, barbiturates, or general anesthetics; opioids

Front 84

Flumazenil Is indicated for the complete or partial reversal of the _____ effects of BZs in cases where ....(3).....

Back 84

sedative;

general anesthesia has been induced/maintained with BZs;
sedation has been produced with BZ for dx and tx studies;
management of BZ overdose (as an adjunct to supportive measures)

Front 85

When using Flumazenil, there is a risk of ____ due to the reversal of BZ effects in high risk populations (what are the three populations?)

Back 85

seizures;

those undergoing concurrent sed-hypnotic withdrawal, those with TCA poisoning, and those with physical dependence to BZs

Front 86

Imipramine is a.....

Back 86

TCA

Front 87

Amitriptyline is a....

Back 87

TCA

Front 88

Nortryptilline is a.....

Back 88

TCA

Front 89

Clomipramine is a......

Back 89

TCA

Front 90

Phenelzine is a....

Back 90

MAOI

Front 91

Trazodone is a ......

Back 91

atypical antidepressant

Front 92

Buproprion is a.....

Back 92

atypical antidepressant

Front 93

Fluoxetine is a.....

Back 93

SSRI

Front 94

Paroxetine is a....

Back 94

SSRI

Front 95

Sertraline is a....

Back 95

SSRI

Front 96

Citalopram is a....

Back 96

SSRI

Front 97

Venlafaxine is a .....

Back 97

dual-mechanism antidepressant

Front 98

Duloxetine is a....

Back 98

dual mechanism antidepressant

Front 99

Nefazodone and Mirtazapine are....

Back 99

'other' third generation antidepressants

Front 100

Which antidepressant categories are first gen drugs?

Back 100

TCAs and MAOIs

Front 101

Which antidepressant categories are second gen drugs?

Back 101

atypical antidepressants

Front 102

Which antidepressant categories are third gen drugs?

Back 102

SSRIs, dual mecahnism and others

Front 103

When treating depression, which drug class is tried first due to its efficacy, tolerability and once daily dosing?

Back 103

SSRIs

Front 104

What are some potential side effects that can be experienced with depression and therapy?

Back 104

GI (N/V)
CNS stimulation/activation (agitation, restlessness, insomnia, anxiety)
Sexual dysfunction (Delayed arousal, anorgasmia, impotence)
Sedation
Weight gain
Withdrawal syndrome
Anticholinergic effects (dry mouth, constipation)
Arrhythmias
Orthostatic hypotension, hypertensive crisis
Serotonin syndrome

Front 105

What is the black boxed warning associated with SSRI use in pts up to age 24?

Back 105

increased suicidal tendencies

Front 106

What are the advantages of adding another antidepressant to a current treatment instead of switching the type?

Back 106

avoids risk of withdrawal sx's, maintains any benefit of first drug, diff MOA may counteract side effects

Front 107

What is the most common antidepressant combination?

Back 107

SSRI plus bupropion

Front 108

MAOI combinations can lead to what two conditions?

Back 108

hypertensive crisis and serotonin syndrome

Front 109

Venlafaxine/SSRI combo has caused _______ due to........

Back 109

spontaneous bleeding; platelet serotonin release and inhibition of platelet aggregation

Front 110

What is the most common augmenting agent (non-antidepressant)? What does it improve?

What are the second-line augmenting agents?

Back 110

buspirone; SSRI-induced sexual dysfunction;

atypical antipsychotics

Front 111

TCAs block the reuptake of ____, ____ or both from the synaptic cleft back into the _____ nerve terminal.

How long is required for antidepressant effects, even though blockade of reuptake occurs immediately?

What other receptors do TCAs also block (3)?

Back 111

NE, 5HT; presynaptic;

2-4 weeks;

histamine 1, muscarinic, and alpha 1 adrenergic receptors

Front 112

TCAs have a ____ therapeutic window.

Back 112

narrow

Front 113

Anticholinergic actions include: (6)

Back 113

dry mouth, constipation, urinary retention, mydriasis, blurred vision, tachycardia

Front 114

Which TCA has the highest anticholinergic actions?

Back 114

amitryptilline

Front 115

What three cardiovascular ADRs can be experience with TCAs?

Back 115

orthostatic hypotension, conduction abnormalities, tachycardia

Front 116

Orthostatic hypotension caused by TCA use is due to _____ blockade. Highest rate seen with _________

Back 116

alpha1 blockade;

amitryptiline

Front 117

What conduction abnormalities can occur with the use of TCAs?

Back 117

EKG abnormalities, altered intraventricular conduction, may cause AV block (in pts with preexisting conduction defects)

Front 118

The conduction abnormalities that may be experienced with TCAs is highest with ______.

Back 118

amitryptiline

Front 119

Tachycardia experienced with use of TCAs is caused by a combination of ____________ and _________

Back 119

reflex response to orthostatic hypotension; anticholinergic effects

Front 120

What CNS ADR can be experienced with TCAs?

Back 120

sedation

Front 121

What are some symptoms of overdose of TCAs?

Back 121

slurred speech, confusion, tachycardia, hypotension, resp distress, QT prolognation, seizures

Front 122

What is a common side effect experienced with antidepressant treatment?

Back 122

weight gain

Front 123

Use of TCAs and Clonidine together is contraindicated due to reports of.....

Back 123

hypertensive crisis (mechanism unknown)

Front 124

TCAs potentiate the actions of which two types of drugs?

Back 124

antimuscarinics and CNS depressants

Front 125

MAOIs with concurrent use of TCAs may cause severe ____ toxicity (consequences=(3)).

Back 125

CNS; hyperpyrexia, seizures, coma

Front 126

Want to avoid concurrent use of TCAs with class IA antiarrhythmics which predispose a pt to....

Back 126

conduction disturbances

Front 127

When dosing TCAs, want to start at the ____ end of the dose range and give the total daily dose divided up. You can then increase the dose to obtain maximal effects as long as ......

The total daily dose may be given as a single dose at _______ after the initial period of use.

do not d/c abruptly because....

Back 127

low; side effects are tolerated;

bedtime

it may cause withdrawal syndrome of 'cholinergic rebound'

Front 128

Clomipramine is indicated only for the treatment of ____

Has strong ___ and ___ actions, can cause __________ (aka "_______". Want to take with food to prevent _______. Can cause _________

Back 128

OCD;

anticholinergic; sedative; orthostatic hypertension (first dose syncope); N/V; sexual dysfunction

Front 129

Trazodone functions by inhibiting the reuptake of ______.

Want to give at bedtime due to its strong _____ Effect.

Advantages include a decreased incidence of ____ and ____ side effects and it is less toxic in______.

Common ADR= _____/_____

Associated with a rare incidence of _____.

DI: Potentiates _______ drugs.

Useful in severe ____ Secondary to depression

Back 129

serotonin;

sedative;

anticholinergic, antihistaminergic; overdose;

sedation/drowsiness;

priapism;

CNS depressant;

insomnia

Front 130

Bupropion may be considered a prodrug with an active metabolite that is a strong reuptake inhibitor of ____.

It lowers ______ threshold and an immediate-release dosage form is rarely used since it is associated with a higher frequency of ______

Back 130

NE;

seizure; seizure

Front 131

Major pharmacological action of SSRIs is a ____ and ____ inhibition of ____ reuptake.

Are the DOCs in treating ____, _____ and _____.

Have largely replaced ____ for initiation and maintenance of therapy.

Back 131

selective; potent; serotonin;

depression, OCD, panic disorder;

TCAs

Front 132

SSRIs have minimal effects on _____, _____ or ____ receptors.

Have a ____ therapeutic index.

Withdrawal symptoms (____.____ and _____) may occur especially after chronic use of high doses

Back 132

muscarinic, adrenergic, or histaminergic;

high;

anxiety, dizziness, nausea

Front 133

SSRIs work to increase serotonin levels at the synaptic cleft which results in .......

The time course of this process correlates with the onset of......

Back 133

the serotonin autoreceptors to down regulate and become desensitized;

therapeutic actions

Front 134

Withdrawal syndrome is more significant with ___-acting SSRIs.

This is attributed to the ______ of 5HT receptors during tx.

FLUSH symptoms=

NOTE *Appearance of withdrawal syndrome may be greatly delayed after SSRI is d/c *

Back 134

shorter;

downregulation;

Flu-like sx, Lightheadedness, Uneasiness (anxiety), Sleep disturbances (insomnia), Headache

Front 135

How can you treat sexual dysfunction caused by SSRI treatment?

Back 135

decreasing dose of SSRI or switching to another antidepressant of a diff class (bupropion)

Front 136

What two pathways are altered by SSRIs that can cause sexual dysfunction?

Back 136

Mesolimbic and Descending pathways from BS to SC

Front 137

In the mesolimbic pathway, SSRIs increase the ____ levels which results in stimulation of _____ Receptors. This disinhibits serotonergic pathways innervating the mesolimbic _____ system. By doing this, SSRIs _____ the dopamine system and results in which sexual dysfunction symptoms (2)?

Back 137

serotonin; 5HT2; dopamine; oppose; decreased libido, anorgasmia

Front 138

SSRI-induced disinhibition of the descending serotonergic pathways (from the brainstem to the SC) increases ____ release which inhibits sexual function (_______, _______).

Back 138

Serotonin; impotence, ejaculatory failure

Front 139

Bupropion is a reuptake inhibitor of both _____ (potent) and ____ (Weaker). Have been reports of several reversals of SSRI-induced _________, _________ and _______

Back 139

NE; dopamine; impotence, decreased libido, delayed orgasm

Front 140

Cyproheptadine is a _______ drug commonly used for _______ that also acts as a __________ agent. By blocking this receptor, it may reverse the SSRI-induced ________ in both genders and ________

Back 140

antihistamine; pruritis; serotonin-receptor blocking; impotence; impaired ejaculation

Front 141

Buspirone has demonstrated improvement of SSRI-indcued ________ and _______

Back 141

anorgasmia and decreased libido

Front 142

Exrapyramidal symptoms (_____) that may be experienced with SSRI use are due to an excess of ____ and a decreased ____ Activity

Back 142

tremors; serotonin; DA activity

Front 143

Which SSRI drug has the highest incidence of weight gain?

Back 143

paroxetine

Front 144

SSRIs block serotonin reuptake into platelets and depletes platelet 5HT which results in ......

3x increase risk of ____ bleeding

Back 144

inhibition of coagulation;

GI

Front 145

Concurrent use of MAOIs and SSRIs is contraindicated due to the prevalence of _________

Back 145

serotonin syndrome

Front 146

SSRIs inhibit which metabolism system? specifically _____.

Back 146

P450; 2D6

Front 147

What the symptoms of serotonin syndrome?

Back 147

rigidity, diaphoresis and hyperthermia

Front 148

Which drug is the prototype SSRI?

Back 148

fluoxetine

Front 149

Fluoxetine is indicated for the acute and maintenance treatment of ____, ____, _____ and _____

Can also be used for ________

Back 149

Major depressive disorder, OCD, bulimia nervosa, panic disorder;

PMDD

Front 150

What are some ADR of Fluoxetine? (3)

Back 150

CNS stimulation (nervousness, anxiety, agitation, insomnia); GI disturbances, Increased risk of GI bleeding

Front 151

Fluoxetine has serious interactions with MAOIs so need to wait _____ weeks after d/c before starting the MAOI

Back 151

5

Front 152

Fluoxetine inhibits ____ and ___ isozymes of the P450 system

Back 152

2D6, 3A4

Front 153

When using Fluoxetine with Dextromethorphan the pt can experience ___________

Back 153

hallucinations

Front 154

Fluoxetine and Warfarin can increase bleeding ________

Back 154

diathesis (susceptibility to bleeding)

Front 155

Paroxetine is indicated for ________, _____, _______, _____ and ____

Is a potent inhibitor of the _____ isozyme of the P450 system.

Paxil CR is a combined delayed release and extended release tablet, with a purpose to decrease _____ and ________

Back 155

Major depressive disorder, OCD, panic disorder, GAD, PTSD;

2D6;

nausea; other GI disturbances

Front 156

Which drug has the highest sedative activity of SSRIs and the most significant risk of DIs?

Back 156

fluvoxamine

Front 157

Which SSRI has possibly the lease potential for DIs?

Back 157

citalopram

Front 158

Up to 70% of pts with panic disorder also fulfill the dx criteria for ____.

_______ has an approved indication for this treatment.

Back 158

major depressive disorder;

alprazolam

Front 159

What are the advantages of using an SSRI in treatment of panic disorder?

Back 159

little to no abuse potential; very low-no incidence of orthostatic hypotension, anticholinergic side effects or sedation

Front 160

Which SSRI has the most CNS stimulating ability?

Back 160

fluoxetine

Front 161

What are the disadvantages of using an SSRI in the treatment of panic disorder?

Back 161

CNS stimulating side effects , DIs due to the inhibition of P450 system, and sexual dysfunction

Front 162

In the treatment of panic disorder, _______ have been found efficacious but the onset of action may be quite _____. The current view is that these drugs may be the DOC for panic disorder with ________

Back 162

SSRIs; slow; concurrent depression

Front 163

Serotonin syndrome most often occurs in patients taking two or more drugs that......

Usually involves ____, ____ and ____.

Excessive stimulation of the ____ and ____ receptor subtypes are responsible for most of the symptoms.

Back 163

increase serotonin levels by different mechanisms.

MAOIs, SSRIs, TCAs

5HT1a and 5HT2a

Front 164

What is the triad of serotonin syndrome?

Back 164

altered mental status, autonomic hyperactivity and neuromuscular abnormalities

Front 165

Mental status changes associated with serotonin syndrome can inlude...

Back 165

agitation, confusion, delirium

Front 166

Autonomic changes associated with serotonin syndrome can include....

Back 166

N, fever, diaphoresis, HTN, tachycardia, tachypnea

Front 167

NM changes associated with serotonin syndrome can include....

Back 167

rigidity, myoclonus (rhythmic muscular contractions), hyperreflexia, shivering, tremor, hyperthermia

Front 168

Drugs that can cause serotonin syndrome include:

Back 168

L-tryptophan, MAOIs (with another drug), amphetamines, cocaine, TCAs, SSRIs,meperidine, dextromethorphan, buspirone, triptans

Front 169

L-tryptophan can cause serotonin syndrome because it functions to....

Back 169

increase 5HT synthesis

Front 170

Most cases of serotonin syndrome caused by MAOIs were used concurrently with _____, ____, _____ a ____ or _____

MAOIs function to decrease...

Back 170

meperidine, tryptophan, dextromethorphan, TCA, SSRI

5HT metabolism

Front 171

MAOI-SSRI combination may produce a serotonin syndrome lasting for ______ after d/c due to....

Back 171

weeks;

SSRIs long-half life and MAOIs long DOA

Front 172

Amphetamines and cocaine cause serotonin syndrome by increasing....

Back 172

5HT release

Front 173

Some TCAs, SSRIs, meperidine and dextromethorphan all function to inhibit....

Back 173

5HT reuptake

Front 174

Buspirone and triptans can cause serotonin syndrome because they are....

Back 174

specific 5HT agonists

Front 175

Venlafaxine is a potent reuptake inhibitor of....

Has minimal effects on _____, ____ or _____ receptors

Weakly inhibits _______ (much less potent that SSRIs) and has serious reaction with _____ (_____, _____, _____ and ____)

Back 175

both NE and 5HT;

cholinergic; adrenergic; or histaminic receptors;

P450 system; MAOIs, hyperthermia, rigidity, myoclonus, seizures

Front 176

Duloxetine is a potent reuptake inhibitor of....

Has low affinity for ____, ____, ____ and ____ receptors.

Indicated for ______ and _____

Moderately inhibits ____ so concurrent use with ____ is not recommended and concurrent use with _____ is contraindicated.

Back 176

NE and 5HT (SNRI)

dopaminergic, adrenergic, cholinergic, and histaminic;

major depressive disorder, GAD

2D6; thioridazine; MAOIs

Front 177

Mirtazapine blocks the central presynaptic ____ receptors and results in an increased release of .......

It selectively enhances neurotransmission over ____ receptors.

It also blocks several postsynaptic ____ receptor subtypes (___,___ and ___). These subtypes are responsible for ______ and _____ ADRs so by blocking them, they are avoided.

Has minimal to no effects on the reuptake of.....

Blocks ____ receptors resulting in potent _____.

Back 177

alpha-2; NE and 5HT;

5HT1;

5HT; 2A, 2C, 3; GI Adverse reactions and sexual dysfunction;

NE or 5HT;

histamine H1; sedation

Front 178

What are two ADRs associated with Mirtazapine?

Back 178

sedation and increased appetite/weight gain due to blockage of 5HT3 receptors

Front 179

Mirtazapine has _____ sedative/psychomotor effects with some drugs and has _____ interactions but doesn't appear to inhibit metabolism of any other drugs.

Back 179

additive; MAOI

Front 180

MAOIs function by blocking the enzyme _____ and preventing the metabolic degradation of ________ to increase concentrations at the synaptic cleft.

Onset of action is _____ days for maximal inhibition but therapeutic effects take _____ weeks.

Long DOA is due to ___________ and 1 week or longer is required to resynthesize the enzyme after rate drug is d/c

Back 180

MAO; biogenic amines (NE, DA, 5HT)

2-3; 2-3;

irreversible inhibition of MAO

Front 181

Indications for MAOIs include: (3)

Back 181

atypical depression, phobic anxiety syndromes, lack of response to other antidepressants (refractory depression)

Front 182

What are some ADRs of MAOIs?

Back 182

orthostatic hypotension, tachycardia, palpitations, sexual dysfunction

Front 183

What are some symptoms of MAOI overdose?

Back 183

hyperpyrexia, HTN, agitation, hallucinations, seizures

Front 184

MAO normally metabolizes ____ in the GIT which is found in some foods. With the MAO inhibited by MAOIs, this is not digested and is absorbed and can cause release of massive amounts of ____ from ___________

This can result in _____ and other signs of adrenergic stimulation such as.....

Treatment=

Back 184

tyramine; NE; adrenergic nerve terminals;

HTN crisis; acute elevation of BP, tachycardia, agitation, headache, sweating, pallor, stroke;

alpha blockers (phentolamine)

Front 185

What is the first line DOC for the treatment of mania in Bipolar 1 disorder?

What are some alternatives?

Back 185

Lithium or divalproex sodium;

AAPs and carbamazepine

Front 186

When a pt is in Euphoric mania, what is the DOC? what is the alternative?

Back 186

lithium; divalproex sodium

Front 187

When a pt is in Dysphoric mania, what is the DOC? what is the alternative?

Back 187

Divalproex sodium; lithium

Front 188

What is the FDA approved maintenance therapy for bipolar 1 disorder? What is the alternative?

Back 188

lithium; lamotrigine and some AAPs

Front 189

What is the DOC for treating rapid cycling bipolar disorder?

Back 189

divalproex

Front 190

What is the 1st line DOC for treating bipolar depression?

What is the second line?

Back 190

lithium;

olanzapine/fluoxetine (symbyax)

Front 191

Lithium has a ____ therapeutic index which requires _____.

Back 191

narrow; monitoring

Front 192

What are some side effects of therapeutic doses of lithium?

Back 192

GI distress, polyuria/dipsia and fine tremor of the hands

Front 193

What are some side effects of chronic treatment with lithium?

Back 193

Nephrogenic Diabetes insipidus, hypothyroidism, wt gain, edema

Front 194

When using lithium, need to be cautious to avoid ____ because it can cause....

Back 194

dehydration; lithium retention and toxicity

Front 195

Moderate toxicity effects of lithium present as....

Back 195

coarse tremor, muscle twitches, slurred speech, unsteady gait and ataxia

Front 196

Increased sodium intake decreases renal _____ of lithium while reduced sodium intake ______ lithium serum levels.

Pts on a sodium restricted diet or diuretics are at risk for....

Back 196

reabsorption; increases;

lithium toxicity

Front 197

Serum lithium concentrations are increased by ______ and ____ due to sodium _____ as well as ____ which cause volume depletion and lowers GFR resulting in......

Back 197

thiazide diuretics; NSAIDs; depletion; ACEIs; reduced lithium excretion

Front 198

Carbamazepine and antipsychotics may cause neurotoxicity within _____ lithium levels

Back 198

normal

Front 199

What is a contraindication for lithium treatment?

Back 199

serious renal disease with unpredictable variations

Front 200

What are some long term adverse effects of divalproex sodium?

Back 200

tremor, thrombocytopenia

Front 201

What is a more serious side effect of divalproex sodium therapy?

Back 201

hepatotoxicity

Front 202

What are the most common adverse effects of divalproex sodium treatment

Back 202

GI disturbances (lessened with food) and sedation

Front 203

Extended release carbamazepine is indicated for _____ or _____ episodes associated with bipolar disorder.

Back 203

acute manic; mixed

Front 204

What are the most common ADRs for carbamazepine?

Back 204

sedation, dizziness, rash, GI disturbances

Front 205

What are some hematological ADR effects of carbamazepine?

Back 205

leukopenia

Front 206

Carbamazepine can induce ____ and ____ conditions

Back 206

SIADH and hyponatremia

Front 207

Carbamazepine induces the _____ system and also auto induces its own_________

Can cause neurotoxicity when combined with _____ even when plasma levels of both are in therapeutic range. Symptoms include......

Back 207

P450 system; metabolism;

lithium; confusion, weakness, coarse tremor, lethargy, hyperreflexia, ataxia

Front 208

Antipsychotic therapy for schizophrenia should be directed towards the _________type.

First generation agents are effective in treating _______ but much less at treating _____ (may even worsen them)

Back 208

dominant;

positive symptoms; negative symptoms

Front 209

Atypical antipsychotic are antagonists at _____ and ____ receptor types.

Clozapine like antipsychotics have low ____ antagonism and high _____ antagonism

Non-clozapine like antipsychotics are relatively specific for ____ receptors in the _____ pathway. Have moderate to high ____ antagonism. Have high ____ antagonism.

Back 209

DA; 5HT;

D2; 5HT2A;

D2; mesolimbic; D2; 5HT2A

Front 210

The blockade of 5HT2A by non-clozapine like antipsychotic drugs causes ____ release in the _____ pathway (lessens _____ symptoms and some ___ symptoms)

Back 210

DA; nigrostriatal; extrapyramidal; negative

Front 211

Aripiprazole has partial ____ and _____ properties at D2 receptors.

Back 211

agonist and antagonist

Front 212

Typical antipsychotic agents are used in the treatment of _______ (_______ and ____).

Major targets are the ____ symptoms.

Can also be used as an _____

Back 212

psychoses (schizophrenia; paranoia);

positive;

antiemetics

Front 213

Which drugs are tended to be used more of the typical antipsychotic drugs?

Back 213

high potency drugs (haloperidol and fluphenazine)

Front 214

Typical antipsychotic agents have erratic and incomplete bioavailibility when taking ______ preparations so want to use.....for rapid initiation of treatment

Back 214

oral; parenteral formsMO

Front 215

What is the MOA of typical antipsychotic drugs?

Back 215

block dopamine receptors (D3 receptor subtype)

Front 216

What are the 4 central dopaminergic pathways?

Back 216

mesolimbic, mesocortical, nigrostriatal, tuberinfundibular

Front 217

What causes the positive symptoms of schizophrenia?

How do you treat this?

Back 217

overactivity of dopaminergic neurons in the mesolimbic pathway and limbic system;

blockade of DA receptors

Front 218

What causes the negative symptoms and cognitive deficiency symptoms of schizophrenia?

What happens if you block DA receptors in this area?

Back 218

decreased dopaminergic activity in the mesocortical pathway;

may worsen negative symptoms

Front 219

Interruption of the dopaminergic transmission in the nigrostriatal pathway causes.....

Neuroleptic blockade here causes....

Back 219

parkinsons disease;

pseudo-Parkinsonism

Front 220

The DA in the tuberinfundibular pathway functions to...

Blockade of this results in...

Back 220

inhibit prolactin secretion;

hyperprolactinemia

Front 221

Binding of antipsychotic drugs to D2 is strongly correlated with both ______ and ________

Back 221

antipsychotic action; toxicity (Extrapyramidal symptoms)

Front 222

Blocking the mesocortical pathway (with DA already deficient) causes:

Back 222

worsened negative symptoms

Front 223

Blocking the DA in the nigrostriatal pathway causes:

Back 223

Extrapyramidal symptoms

Front 224

Blocking the DA in the tuberinfundibular pathway causes:

Back 224

hyperprolactinemia

Front 225

Extrapyramidal symptoms are seen in Haloperidol _____Than in Chlorpromazine.

Back 225

more

Front 226

What are some extrapyramidal symptoms that may be seen with antipsychotics?

Back 226

acute dystonias, akathisias, pseudo-Parkinsonism

Front 227

How do you treat acute dystonias (EPS) associated with typical antipsychotics?

Back 227

prophylactic use of anticholinergic (1st gen antihistamine with anticholinergic properties preferable)

Front 228

How do you treat akathisias (EPS) associated with typical antipsychotics?

Back 228

beta blocker or BZs

Front 229

How do you treat pseudo-parkinsonism (EPS) associated with typical antipsychotics?

Back 229

anticholinergics

Front 230

What are some ADRs associated with typical antipsychotics?

Back 230

EPS, tardive dyskinesias, sedation, anticholinergic effects, orthostatic hypotension, others (photosensitivity, poikilothermia, hyperprolactinemia, thioridazine)

Front 231

Akathisias is=

Back 231

unpleasant sensitization of inner restlessness with the inability to sit still

Front 232

Tardive Dyskinesias is caused by...

Is...

Back 232

the long-term blockade of D2 receptors which causes up-regulation and supersensitivity of D2 receptors;

a late developing EPS syndrome of abnormal choreoathetoid movements

Front 233

Tardive dyskinesias are very serious, potentially ______ and very resistant to _______.

Characterized by.....

Back 233

irreversible; drug treatment;

involuntary movements and abnormal facial movements

Front 234

Which two typical antipsychotic drugs cause more sedation than haloperidol and what causes it?

Back 234

chlorpromazine; thioridazine;

blockade of central H1 receptors

Front 235

Which two drugs cause more anticholinergic effects/sedation than haloperidol?

This is because of the blockade of ________ receptors and also results in a ______ and ______

Back 235

chlorpromazine; thioridzine;

peripheral muscarinic; dry mouth; constipation

Front 236

Which two drugs cause more cases of orthostatic hypotension than haloperidol?

What causes this?

Back 236

chlorpromazine; thioridizine;

blockade of alpha 1 receptors

Front 237

Which typical antipsychotic has the highest incidence of photosensitivity?

Back 237

chlorpromazine

Front 238

Which typical antipsychotic prolongs the QT interval?

Back 238

thioridazine

Front 239

What are the 4 typical antipsychotic drugs?

Back 239

chlorpromazine, thioridazine, haloperidol, prochlorperazine

Front 240

Chlorpromazine is indicated for ....(5).....

Back 240

psychotic disorders, control N/V, tx of acute intermittent porphyria, adjunct in tx of tetanus, relief of intractable hiccups

Front 241

Thioridazine has a black boxed warning because of.....

Back 241

QT prolongation

Front 242

Haloperidol is a ____ potency agent with very strong ________ symptoms. Has the highest incidences of ____ and ____

Back 242

high; extrapyramidal symptoms; EPS, TD

Front 243

Prochlorperazine is used for ______. Is not used as an antipsychotic due to its.....

Back 243

antiemetic; strong extrapyramidal symptoms

Front 244

Atypical antipsychotic drugs are referred to as atypical because....

Back 244

therapeutic efficacy can be achieved without significant extrapyramidal symptoms

Front 245

Atypical antipsychotic drugs are antagonists at _____ and ____ receptors but more more selective for ________ receptors.

5HT activity at 5HT2 receptors decreases the _____ levels which contributes to the negative symptoms experienced. By blocking the 5HT2 receptors, _______ is able to increase leading to relief from negative symptoms.

Back 245

5HT2 and D2 (central);

limbic-specifc D2 receptors

dopamine; dopamine

Front 246

Atypical antipsychotic agents usually display ______cognitive fxn in schizo's where as typical agents generally have a negative effect on cognitive fxn.

Back 246

improved;

Front 247

Atypical antipsychotic drugs are effective in the treatment of many schizo pts who are....

Also effective against the _____ symptoms

Back 247

resistant to typical antipsychotic drugs


negative

Front 248

Atypical antipsychotic agents improve ________, significantly reduce _________symptoms, leaves unchanged or minimally elevates ________ and has a decreased or absent propensity to produce _____.

Back 248

cognitive function; both positive and negative symptoms; prolactin levels; EPS's

Front 249

Clozapine has two separate interactions=

Back 249

central and peripheral

Front 250

Clozapine (in regard to central receptor interactions) is a relatively weak antagonist at ____ receptors which is the site of action of most other antipsychotics. Results in little to no ____ stimulation.

Also have a strong blockade of ______ receptors which modulates DA release; may account for minimal risk of _____ and a lower risk of ____ compared to typicals.

Back 250

D2; prolactin;

5HT2; EPS; TD

Front 251

What are the three receptors blocked by Clozapine in the periphery?

Back 251

alpha1, histamine 1, msucarinic

Front 252

Clozapine causes an alpha1 blockade which results in=

Histamine 1 blockade results in=

Msucarinic blockade results in=

Back 252

orthostatic hypotension;

sedations;

anticholinergic effects

Front 253

Clozapine is indicated in psychotic pts who have....

tx with clozapine is limited to...

Back 253

tried and failed 2 other antispychotic classes of drugs (either failed tx or couldnt tolerate adverse effects);

resistant pts

Front 254

Clozapine has a black boxed warning for: (5)

Back 254

agranulocytosis, potent anticholinergic effects (constipation), sedation, metabolic effects (wt gain, DM, dyslipidemias) and QT prolongation

Front 255

Risperidone is a....

Back 255

atypical antipsych

Front 256

Clozapine is a....

Back 256

atypical antipsych

Front 257

Olanzapine is a....

Back 257

atypical antipsych

Front 258

Ziprasidone is a...

Back 258

atypical antipsych

Front 259

Aripiprazole is a...

Back 259

atypical antipsych

Front 260

Paliperidone is a...

Back 260

atypical antipsych

Front 261

Iloperidone is a...

Back 261

atypical antipsych

Front 262

Asenapine is a...

Back 262

atypical antipsych

Front 263

Lurasidone is a....

Back 263

atypical antipsych

Front 264

Risperidone is indicated for...

Back 264

the management of schizo; NOT restricted to resistant pts

Front 265

Risperidone is the first drug approved for the tx of irritability in children and adolescents with ______

Back 265

autism

Front 266

Risperidone is the 1st _______ atypical drug.

Back 266

long-acting injection

Front 267

Risperidone has a lower incidence of ______ compared to clozapine, lower incidence of dose-dependent _______ than clozapine, has incidence of _____________ and has no reported incidences of ________

Back 267

seizurs; EPS; QT interval prolongation; agranulocytosis

Front 268

Risperidone has a strong affinity for ____ and ____ receptors where it is a potent _____

Back 268

5HT2 and D2; antagonist

Front 269

The Potent 5HT antagonism actions of Risperidone accounts for the relatively low incidence of _____ Despite strong D2 antagonism (comparable to ______). Incidence of EPS is ______with clozapine

The D2 antagonism does result in a dose-related increase in _________

Back 269

EPS; haloperidol; lower;

prolactin secretion

Front 270

Olanzapine has similar receptor binding and activity as _______

Back 270

clozapine

Front 271

Indications for olanzapine include management of _____ and as a mono therapy or adjunct therapy for short-term treatment of ______ or ______ associated with __________disorder

Back 271

schizophrenia; acute manic, mixed episodes; bipolar 1 disorder

Front 272

Olanzapine treatment is not restricted to...

Back 272

resistant pts

Front 273

What ADRs have not been demonstrated with Olanzapine?

Olanzapine has significant ______ effects including....

Back 273

leukopenia or agranulocytosis;

metabolic; high risk of DM, dyslipidemia, high amount of wt gain

Front 274

Ziprasidone is indicated for the treatment of....

Has the least amount of associated __________.

Is a 2nd line agent due to the_____________ that occurs to a greater extent than for any other antipsychotic drug except for _________

Back 274

both positive and negative symptoms of schizophrenia;

metabolic syndrome;

QT prolongation; thioridazine

Front 275

Aripiprazole is a partial agonist at ______ receptors. Is an antagonist when ______ is present and an agonist when .....

ADR include:

Back 275

D2; excess DA is present; DA is deficient;

prolongs QT interval

Front 276

Paliperidone is the active metabolite of _______.

ADR includes .......

Want to avoid concurrent use of other drugs which.....

Back 276

risperidone;

prolongation of QT;

prolong QT interval

Front 277

Iloperidone has been associated with ______ and not _______

Back 277

prolonged QT interval; wt gain

Front 278

Asenapine has been associated with ______ so you need to avoid use of concurrent agents which also _______ and in pts with ....

Back 278

prolonged QT interval; prolongate the QT interval; risk factors for prolonged QT intervals

Front 279

Lurasidone did not report any _________

Back 279

Qt prolongation

Front 280

Neuroleptic malignant syndrome is characterized by what 4 things?

Most commonly seen with _______ and ______.

Thought to be due to......

Treatment:

Back 280

rigidity, hyperthermia, tachycardia, sweating;

haloperidol, fluphenazine;

excessive blockade of postmen DA receptors causing a severe DA depletion and a severe extrapyramidal syndrome

muscle rigidity= IV dantrolene

Front 281

atypical antipsychotic drug therapy is associated with _______, ________, _______ and ________

Back 281

impaired glc metabolism; exacerbation of existing DM I and II, new onset DM II and diabetic ketoacidosis

Front 282

Atypical antipsychotics may cause ____, ___, and ______ increasing the risk for _______

Which drug was associated with a greater weight gain and metabolic abnormalities?

Which drug was associated with improvement in most metabolic states and showed the least amount of metabolic syndrome?

Back 282

weight gain, DM, dyslipidemias; developing metabolic syndrome;

olanzapine;

ziprasidone

Front 283

To minimize weight gain and metabolic effects when using atypical antipsychotics, which do you want to use? which do you want to avoid?

Back 283

aripiprazole, ziprasidone;

olanzapine, clozapine, quitiapine

Front 284

Which atypical antipsychotic drugs should you avoid if you want to minimized QT prolongation?

Back 284

ziprasidone, iloperidone, paliperidone