BCACP – Clinical Test Questions With All Correct Answers

BCACP – Clinical Test Questions With All Correct Answers FDA approved tx for PTSD - ANSWER- parox sert FDA approved tx for OCD - ANSWER- fluox fluvox parox sert cloipramine Which z-hypotics can be repeated if pt has >4 hrs to sleep? - ANSWER- zolpidem (SL tabs) zalepon (Sonata) Which z-hypotics are not a 3A4 sub (less DDI) - ANSWER- zalepon (Sonata) Which sleep med has fastest onset - ANSWER- zolpidem Which sleep med has slowest onset - ANSWER- temazepam estazolam Which sleep med has longest DoA - ANSWER- quazepam How long will it take for ramelteon to work? - ANSWER- 3 weeks How to dose Doxepin - ANSWER- 3-6 mg 30 min < sleep w/o food DOC for RLS - ANSWER- DA Agonists 1) ropinerole 0.25 1-3 hr < bed (max 4mg) 2) pramipexole 0.125 mg 2-3 hrs < bed (max 0.5 mg) 3) rotigotine patch - for mod-sev 1mg/d (max 3mg), hold x 30 sec and avoid site x 14d RF for RLS - ANSWER- Fe def (supplement if ferritin <50) Which SNRIs have no DDIs - ANSWER- desvenlafaxine milnacipran (approved for fibromyalgia only) 2 week MAIO washout required for all DDIs except ________ (drug) = ________ (time) - ANSWER- fluox = 5 weeks Goal Li level - ANSWER- 0.6-1.2 (depression and maintenance BPD) 1-1.2 if acute BPD FDA BBW for SSRIs re: Preg? - ANSWER- persistent pulm HTN (fetus) Only anitD that you NEED to stop in preg - ANSWER- parox DsOC for rapid cycling - ANSWER- VPA Li Goal VPA lvl - ANSWER- 50-125 BBW for VPA - ANSWER- hep fail pancereatitis Teratogen Blood dyscrasias (thrombo) DDI b/w VPA and LTG - ANSWER- VPA = increased LTG (lower LTG by 50%) BBW for CBZ - ANSWER- aplastic anemia agranulocytosis / neutropenia Screen for HLAB *1502 in asians - increases SJS LTG BBW - ANSWER- SJS - titrate up slow d/t risk (slow onset, not for acute) LTG dose alone, w/ VPA, w/ CBZ - ANSWER- LTG: start 25/d x 2 week, then 50/d (max 200) LTG+VPA: lower dose 50% LTG+CBZ: inc dose 50% Topamax for BPD? - ANSWER- adjunct only - no monothx Which atypical antiPs are approved for maintenance of BPD (vs only acute) - ANSWERolanz quetiapine Both also ok for acute Mood stabilizers to avoid in preg - ANSWER- Li VPA CBZ Top - face defect olanz - increased wt and preeclampsia Which antiPs are preg B? - ANSWER- clozapine lurasidone Which antiPs have greatest risk of hyperprolactinemia - ANSWER- typical APs risperidone paliperiodne which antiPs increase QTc the worst? - ANSWER- thioridazine (BBW) Pimozide Haldol (IV) quetiapine which drugs have BBW of increased risk of death in dementia - ANSWER- antiPs which atypical antiPs have high sedation - ANSWER- clozaril quetiapine zypeza which atypical antiPs have highest risk of EPS - ANSWER- cariprazine (Vraylar) latuda important counseling point for Latuda admin - ANSWER- take w/ 350 cal for increased abs important counseling point for paliperidone - ANSWER- ghost tab in stool what ANC is needed to start Clozapine? when should you stop? - ANSWER- 1500 to start stop at 1000, but can restart when >1000 stop forever at 500 tx for akathesia (restless/agitation) - ANSWER- low dose propranolol + ativan or mirtaz avoid ACh tx for TD - ANSWER- stop/change AP valbenazine (Ingrezza) 40/d x 1 w, then 80/d avoid ACh which AP has no metabolic SEs - ANSWER- latuda which APs have worst wt gain - ANSWER- risp olanz cloz quetiapine BBWs for clozapine - ANSWER- neutropenia sz (dose-dep) myocarditis orthohypoTN dosing for LA inj, po overlap? Haldol Fluphenazine Risperdal Paliperidone (Invega) Zyprexa Abilify - ANSWER- Haldol q4w (no PO if load) Fluphenazine q2w (no PO) Risperdal q3w (3 w PO overlap, need to fridge & reconstitute