OCD and Eating Disorders
There is no FDA-approved medication for this eating disorder.
Anorexia Nervosa
What is the mechanism of action of Dexmedetomidine SL film?
alpha 2 - adrenergic agonist
What is the treatment of choice for PTSD?
Individual, trauma-focused psychotherapy
Which of the following is a key distinguishing feature of Third Generation Antipsychotics (TGAs)?
Partial D2 agonism
What is the target serum concentration range for Valproate?
50-125 mcg/mL
This SSRI is only FDA-Approved for OCD.
Fluvoxamine (Luvox)
What is adverse effect of Loxapine inhalation powder (Adasuve) requires REMS monitoring?
Bronchospasm
What medication can be used for the treatment of nightmares associated with PTSD?
prazosin 1-20 mg nightly
List two BBWs for clozapine
Severe neutropenia
Orthostatic hypotension, bradycardia, syncope
Seizures
Myocarditis, cardiomyopathy, and mitral valve incompetence
Increased mortality in elderly patients with dementia (class warning)
What is the therapeutic drug level range for Lithium in acute mania?
0.8-1.2 mEq/L
This TCA is considered second-line for OCD.
Clomipramine
What is the black box warning for Brexpiprazole?
Increased mortality in elderly patients with dementia-related psychosis
According to research, what is the effect of benzodiazepines on PTSD severity?
Recommend against use of benzodiazepines for the treatment of PTSD
May interfere with extinction of fear response and worsen recovery from trauma
May limit efficacy of evidence-based psychotherapy
High risk of tolerance and dependence
2015 Meta analysis suggests at best BZD are no better than placebo
No improvement in overall severity of PTSD
May worsen overall severity of PTSD as well as depression, aggression, substance use, and anxiety
This extrapyramidal symptom (EPS) is characterized by inner restlessness and inability to sit still.
Inner restlessness and inability to sit still
What type of medication should be initiated in a patient with acute mania who is presenting with fixed, false beliefs not based in reality?
SGA such as:
• Aripiprazole (Abilify®)
• Asenapine (Saphris®)
• Cariprazine (Vraylar®)
• Iloperidone (Fanapt®)
• Olanzapine (Zyprexa®)
• Quetiapine (Seroquel®)
• Risperidone (Risperdal®)
• Ziprasidone (Geodon®)
Lanugo is most commonly a sign or symptoms of which eating disorder?
Anorexia Nervosa
Which second generation antipsychotic has the highest risk for QTc prolongation?
Ziprasidone (Geodon)
Name a first-line medication used for PTSD
Paroxetine, Sertraline, Venlafaxine XR
Which medication is appropriate for treating acute dystonic reactions?
Anticholinergic medications, such as IM diphenhydramine or benztropine
Which medication FDA-approved for bipolar depression requires ≥ 500 calories with administration?
Lurasidone (Latuda)
Inadequate response to an antidepressant should be determined after what timeframe for OCD?
•Inadequate response after 8-12 weeks
•At least 4-6 weeks at the highest comfortably tolerated dose
Lorazepam should be avoided in which acutely agitated patients?
- Those intoxicated with CNS depressants (alcohol, benzodiazepines)
- parenteral with IM olanzapine
Name two benefits of psychotherapy for PTSD vs pharmacotherapy.
- Greater improvement in core PTSD symptoms
- Improvements persist for longer period of time
- Risks of negative side effects are lower
- Benefits of pharmacology may diminish with time or may be lost with medication is discontinued
Valbenazine (Ingrezza) acts through which mechanism?
VMAT2 inhibition
Which hematological adverse effect is associated with Valproate?
Thrombocytopenia