PSYCHOPHARMACOLOGY

Antidepressants

100

Name 4 Common Side Effects of SSRI's 

GI, headache, insomnia, sexual dysfunction

200

Which antidepressant class is most sedating? And, seperately, which SSRI is most sedating? 

TCA, Paroxetine

300

Which class of antidepressants are contraindicated for a patient with cardiac comorbidities? 

***bonus: name all drugs in this class 

TCA's 

Doxepin, Imipramine, Despiramine, Nortriptyline, Trimipramine, Amitriptyline, Maprotiline, Protriptyline, Amoxipine 

400

Which atypical antidepressant has a unique mechanism of action, and what is that mechanism of action? 

**bonus: brand, generic, max dose

Mirtazapine (Remeron) 

• Mirtazapine blocks alpha-2 receptors, preventing them from limiting the release of norepinephrine and serotonin.
• Without the "brake" effect of alpha-2 receptors, more norepinephrine and serotonin are released, helping improve mood and combat depression.

500

Which class of antidepressant medication has a dietary restriction? What is this restriction, and what could consuming this food lead to? 

MAOI, Tyramine (Pizza, Wine), Hypertensive Crisis

Antipsychotics

100

What is the BBW for antipsychotics? 

Increased risk of mortality in patients with dementia and the elderly

200

Which antipsychotic has a different mechanism of action? What makes it different? 

***brand, generic, max dose

Abilify (partial D2 agonist)

Aripiprazole, Abilify, 30 mg. Aristada, 1064 mg

300

Which is the best antipsychotic medication for suicidal patients? 

Clozapine 

400

Which [3] antipsychotics are used as adjunct in treatment resistant depression? 

***bonus: brand, generic, max dose 

Aripiprazole (Abilify) - 30 mg 

Brexpiprizole (Rexulti) - 4 mg

Quetiapine (Seroquel) - 800 mg

500

Which antipsychotics have a unique side effect that impairs vision? What is this side effect, and what could it lead to? 

• Pigmentary Retinopathy (unique side effect of two drugs) - melanin deposits in the eye, could be irreversible and lead to blindness 
  • Thioridazine 
• Corneal Desposits 
• Chlorpromazine

Mood Stabilizers

100

Which drug (not antipsychotic) would be good for an individual with bipolar disorder and suicidality? 

Lithium

200

Name [4] non-psychiatric conditions that can mimic mania 

- Encephalitis

- Delirium

- Post Concussion/Chronic Traumatic Encephalopathy (CTE)

- Stimulant Abuse

300

What are the symptoms of lithium toxicity? How do we reverse it and why might it take multiple rounds? 

• Lithium toxicity - muscle weakness, confusion, vomiting/diarrhea 
  • Below blood levels we looked at tremors (coarse = lithium toxicity)
• To get out, use dialysis. Problem is that it might take multiple rounds b/c lithium is intracellular     

400

How do you determine the dose of mood stabilizing medications? Which mood stabilizer is indicated for liver problems? Which organ does this mood stabilizer have a problem with? 

Serum Concentrations, Lithium, Kidneys

500

Which mood stabilizer is best for pregnancy? Does it work for both acute and continuous episodes? Which mood stabilizer is best if not pregnant? Does it work for both acute and continuous episodes?

Lamictal - Continuous 

Lithium - Acute/Continuous 

Miscellaneous

100

What is the function of CYP450? Where is it located? What happens if you take two drugs that both act on CYP450? 

• (in the liver) breaks down certain substances
  • inducer of CYP450 --> everything breaks down 
  • inhibitor CYP450 --> higher concentration of druv

200

Which antidepressants cause seizures? 

Bupropion 

Amoxepine

Maprotiline

Chlomipramine

300

Which two drugs are indicated for OCD? 

Fluvoxamine, Chlomipramine

400

What is special about carbamazepine? Why would someone be put on this drug? 

Auto-inducer. If on diazepam long term to induce metabolism of the drug so there would be a lower concentration of drug in the body

500

If a patient has a liver problem or is over the age of 65, which benzodiazepine drugs should be prescribed? 

Lorazepam

Oxazepam

Temazepam

Black Box Warnings

100

Bupropion BBW? 

Eating Disorders, Seizures 

200

Which drugs have BBW for Steven Johnson Syndrome? 

Carbamazipine, Lamotrigine/Lamictal

300

Which drug has a black box warning for hepatotoxicity? Which type of drug is this? What is brand, generic, and max dose of this drug? 

Nefazodone, Atypical antidepressant, Serzone, 600 mg

400

Valproic Acid [3] BBW

1. Hepatotoxicity
2. Birth Defects
3. Pancreatitis 

500

Clozapine BBW (5) 

1. Blood stuff
2. Elderly
3. Orthostatic Hypotension     (stand too fast, dizzy and fall)
4. Seizures
5. Myocarditis (Heart Problems)