CERTIFICATION EVALUATION EXAMS FULL
QUESTION SET WITH SOLVED ANSWERS
◉ Dopaminergic Pathways. Answer:
◉ CATIE study. Answer: Clinical Antipsychotic Trial
-Showed life expectance 25 less for SMI
-
◉ STEP-BD study. Answer: Systematic Treatment Enhancement
Program for Bipolar
3 main findings:
-patients in treatment for BPD have a 50/50 chance of achieving full
recovery after two years of treatment.
-Lamictal and inositol better than risperadol with mood stabilizer
and antiD.
-Depakote does increase risk for polycystic oval syndrome (PCOS)
◉ Star-D study. Answer: Sequenced Treatment Alternatives to
Relieve Depression
,-SSRI/SNRI are as effective as TCA's but TCA's have more SFX and
more toxicity.
-After you start one medication then move to the next only a third
will respond to the second med
-Third trial - crap shoot
◉ 5-HT3 and 4 in periphery. Answer: gut- appetite and GI motility
◉ Norepinephrine to cerebellum. Answer: mediate tremors
◉ Norepinephrine urinary. Answer: causes urinary retention (alpha-
1 receptors)
◉ Olanzapine and cigarettes. Answer: nicotine induces olanzapine -
increase dose of Zyprexa with d/c pt if they are going to start
smoking again.
◉ Lamotrigine and Valporate. Answer: Valporate increases serum
levels of Lamotrigine but inhibiting lamotrigines glucoronidation.
-Reduce Lamical dose by 50, and use low dose of depakote.
◉ Lamotrigine and Birth control. Answer: Exogenous estrogen in
oral contraceptives induces metabolism on 1A4 (lamotrigine need to
increase dose up to 50%)
, ◉ Lithium and NSAIDs. Answer: Li level will increase with inhibition
of prostaglandins (ie. aspsirin, tylenol)
◉ First Gen AntiPsych mech of action. Answer: D2 recptor blockade
in mesolimibic and mesocortical tracts
only treats positive symptoms
◉ 1st gen AntiPysch SFX. Answer: -sedation and weight gain
-othrostatic hypotension
-hyper prolactinemia
-EPS
-anticholinergic - sedation
◉ 2nd gen AntiPsycho. Answer: -treat both negative and positive
symptoms because D2 and 5-HT blockade.
-decreased risk of EPS and TD
◉ 2nd Gen AntiPsychotics SFX. Answer: -othrostatic hypotension
-dizziness
-WEIGHT GAIN- metabolic issues
-tachycardia