Module 2 Exam - Psychopharmacology
If a patient is experiencing SSRI related sexual dysfunction what agent should you switch to? -
ANS bupropion
What is the first line agent for anxiety disorders? - ANS Start with SSRI such as fluoxetine,
sertraline, and paroxetine as the first line. REMEMBER! Non-activating antidepressants!
Which has the highest anticholinergic effect: benzo, TCA, or SSRI? - ANS TCAs
Which SNRI can be very activating? - ANS venlafaxine
What symptoms are beta-blockers generally effective for? - ANS Akathisia
What are the signs of serotonin syndrome? - ANS muscle spasms, fever, racing heart,
headache, confusion
Which class of antidepressants are thought to be effective in the treatment of OCD? - ANS
TCAs
For the treatment of panic attacks what agents would you choose? - ANS BENZO initially but
can add long-term SSRI as well
What is the mechanism of action of benzodiazepines? - ANS potentiate effects of GABA
What is a known limitation of benzo treatment? - ANS rebound insomnia
What is the mechanism of action of buspirone? - ANS partial 5HT1A agonist
If the medication is not working, what should you look at before switching the medication? -
ANS the dose
In relation to anxiety, what is happening with the neurotransmitters? - ANS increased
norepinephrine (fight/flight)
decreased GABA (not sleepy)
decreased serotonin (not happy)
What is the first line treatment for chronic anxiety - ANS SSRIs
, When prescribing benzodiazepines what is crucial to know about individual drugs? - ANS
Where they are metabolized. You want to select agents that are metabolized outside of the liver.
Such as lorazepam, oxazepam, temazepam.
What are some side effects of benzodiazepines? - ANS Daytime drowsiness (CNS), Urinary
retention (anticholinergic), Blurred vision (anticholinergic), Constipation (anticholinergic), Dry
mouth (anticholinergic), hallucination, daytime drowsiness
Benzodiazepine withdrawal is like withdrawal from what other substance? - ANS ETOH
What are the symptoms of benzo withdrawal? - ANS insomnia, anxiety, hand tremors, irritability,
anorexia, nausea vomiting, HTN
What do you give to reverse benzos? - ANS flumazenil
What is the only short acting benzo? - ANS midazolam
What are the four intermediate acting benzos? - ANS 1. lorazepam, 2. oxazepam, 3.
temazepam, 4. alprazolam
What are the long acting benzos? - ANS Diazepam, chlordiazepoxide, clonazepam: these are
your massive hangover ones
What are the four non-benzo anxiolytics - ANS buspirone, hydroxyzine, barbiturates, propanol.
What are the side effects of propranolol? - ANS bradycardia, hypotension
What is agoraphobia? - ANS fear of open spaces
What is generalized anxiety disorder? - ANS the general state of tenseness and uneasiness
greater than 6 months
What is the first line treatment for generalized anxiety disorder? - ANS SSRI
What is the second line treatment for generalized anxiety disorder? - ANS buspirone, SNRI,
can augment with benzos
What is the first line treatment of panic disorder? - ANS SSRI, SNRIs
What is the second line treatment of panic disorder? - ANS Limited use of TCAs
What are the adjunct therapies for panic disorder? - ANS Benzos - USE WITH CAUTION! And
only short term until the other meds are effective ALPRAZOLAM
If a patient is experiencing SSRI related sexual dysfunction what agent should you switch to? -
ANS bupropion
What is the first line agent for anxiety disorders? - ANS Start with SSRI such as fluoxetine,
sertraline, and paroxetine as the first line. REMEMBER! Non-activating antidepressants!
Which has the highest anticholinergic effect: benzo, TCA, or SSRI? - ANS TCAs
Which SNRI can be very activating? - ANS venlafaxine
What symptoms are beta-blockers generally effective for? - ANS Akathisia
What are the signs of serotonin syndrome? - ANS muscle spasms, fever, racing heart,
headache, confusion
Which class of antidepressants are thought to be effective in the treatment of OCD? - ANS
TCAs
For the treatment of panic attacks what agents would you choose? - ANS BENZO initially but
can add long-term SSRI as well
What is the mechanism of action of benzodiazepines? - ANS potentiate effects of GABA
What is a known limitation of benzo treatment? - ANS rebound insomnia
What is the mechanism of action of buspirone? - ANS partial 5HT1A agonist
If the medication is not working, what should you look at before switching the medication? -
ANS the dose
In relation to anxiety, what is happening with the neurotransmitters? - ANS increased
norepinephrine (fight/flight)
decreased GABA (not sleepy)
decreased serotonin (not happy)
What is the first line treatment for chronic anxiety - ANS SSRIs
, When prescribing benzodiazepines what is crucial to know about individual drugs? - ANS
Where they are metabolized. You want to select agents that are metabolized outside of the liver.
Such as lorazepam, oxazepam, temazepam.
What are some side effects of benzodiazepines? - ANS Daytime drowsiness (CNS), Urinary
retention (anticholinergic), Blurred vision (anticholinergic), Constipation (anticholinergic), Dry
mouth (anticholinergic), hallucination, daytime drowsiness
Benzodiazepine withdrawal is like withdrawal from what other substance? - ANS ETOH
What are the symptoms of benzo withdrawal? - ANS insomnia, anxiety, hand tremors, irritability,
anorexia, nausea vomiting, HTN
What do you give to reverse benzos? - ANS flumazenil
What is the only short acting benzo? - ANS midazolam
What are the four intermediate acting benzos? - ANS 1. lorazepam, 2. oxazepam, 3.
temazepam, 4. alprazolam
What are the long acting benzos? - ANS Diazepam, chlordiazepoxide, clonazepam: these are
your massive hangover ones
What are the four non-benzo anxiolytics - ANS buspirone, hydroxyzine, barbiturates, propanol.
What are the side effects of propranolol? - ANS bradycardia, hypotension
What is agoraphobia? - ANS fear of open spaces
What is generalized anxiety disorder? - ANS the general state of tenseness and uneasiness
greater than 6 months
What is the first line treatment for generalized anxiety disorder? - ANS SSRI
What is the second line treatment for generalized anxiety disorder? - ANS buspirone, SNRI,
can augment with benzos
What is the first line treatment of panic disorder? - ANS SSRI, SNRIs
What is the second line treatment of panic disorder? - ANS Limited use of TCAs
What are the adjunct therapies for panic disorder? - ANS Benzos - USE WITH CAUTION! And
only short term until the other meds are effective ALPRAZOLAM
