Antidepressants
Which antidepressant should be avoided in patients with epilepsy or eating disorders?
Answer: Bupropion
Rationale: Bupropion lowers the seizure threshold, making it contraindicated for patients with epilepsy or eating disorders.
Name three commonly used medications to treat panic disorder.
Answer: Alprazolam, fluoxetine, clonazepam, sertraline, paroxetine
Rationale: These are standard treatments for panic disorder.
What is the priority intervention for a patient on risperidone with new facial and tongue movements?
Answer: Hold risperidone and notify provider
Rationale: Acute dystonia can compromise airway.
What are at least three adverse effects of tamoxifen?
•Hot flashes
•Fluid retention
•Vaginal discharge
•Nausea and vomiting
•Menstrual irregularities
•Endometrial cancer
•Teratogenic
What condition is suspected when a patient on SSRIs develops clonus, tremor, hyperthermia, and altered mental status?
Answer: Serotonin syndrome
Rationale: Life-threatening reaction to excess serotonin.
How does fluoxetine work to treat depression?
Answer: Selectively inhibits serotonin reuptake
Rationale: Increases serotonin availability at synapses
Why is buspirone considered safer than other anti-anxiety medications?
Answer: Low risk of dependence
Rationale: Unlike benzodiazepines, buspirone does not cause addiction.
Which drug class is associated with tardive dyskinesia, hypotension, and bradykinesia?
Answer: First-generation antipsychotics
Rationale: These cause EPS and cardiovascular effects
Which medication treats anemia caused by chemotherapy?
Answer: Erythropoietin
Rationale: Stimulates RBC production.
What are examples of extrapyramidal symptoms (EPS) from chlorpromazine?
Answer: Severe spasms, rigidity, shuffling gait, pacing
Rationale: EPS includes dystonia, parkinsonism, and akathisia.
What is the most common adverse effect of fluoxetine?
Answer: Sexual dysfunction
Rationale: Fluoxetine often causes sexual dysfunction and CNS stimulation.
What should patients know about buspirone and dependency risk?
Answer: It is not addictive
Rationale: Buspirone has minimal abuse potential.
Which medication is commonly prescribed for short-term insomnia?
Answer: Zolpidem
Rationale: Used for short-term sleep issues.
What is true about alkylating agents?
•Highly reactive compounds
•Cells are killed by alkalization of DNA
•Cell-cycle phase–nonspecific agents
•Drug resistance is common
Toxicities include: Occur in tissues with high growth fraction and Bone marrow, hair follicles, GI mucosa, germinal epithelium
How can patients manage three different types of anticholinergic effects?
Answer:
Why should bupropion not be prescribed for individuals with anorexia nervosa?
Answer: It lowers seizure threshold
Rationale: Electrolyte imbalance in anorexia increases seizure risk.
What are key teaching points for buspirone use?
Answer: Take routinely, not PRN; effect takes weeks
Rationale: Buspirone requires consistent dosing for benefit.
Neuroleptic malignant syndrome reflects depletion of which neurotransmitter?
Answer: Dopamine
Rationale: NMS results from dopamine receptor blockade.
What causes severe nausea and vomiting from chemotherapy?
Answer: Stimulation of chemoreceptor trigger zone
Rationale: Chemotherapy activates this zone in the brain.
What symptoms are associated with serotonin syndrome?
Answer: Hyperreflexia, hypertension, tachycardia, agitation
Rationale: Classic signs of serotonin excess.
What drug class is considered first-line treatment for depression?
Answer: SSRIs
Rationale: SSRIs are effective and safe for initial therapy.
Why should grapefruit juice be avoided with buspirone?
Answer: It increases buspirone levels
Rationale: Grapefruit juice can cause toxicity.
Name at least three adverse effects of haloperidol.
Which lab result would require withholding chemotherapy?
Answer: Low neutrophil count
Rationale: Severe neutropenia increases infection risk.
What condition is indicated by fever, confusion, and lead-pipe rigidity in a patient on antipsychotics?
Answer: Neuroleptic malignant syndrome
Rationale: Life-threatening reaction with autonomic instability.