EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
PLUS A STUDY GUIDE / EOR PSYCH AND BEHAVIORAL
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What is the first line treatment (drug class) for depression? - ANSWER-SSRIs
Selective Serotonin Reuptake Inhibitors.
*SNRIs are also first line, but are not used as often becuase they cause more/worse
adverse effects.
What electrolyte disturbance can SSRIs cause, especially in the elderly? -
ANSWER-Hyponatremia
Which SSRI is FDA approved for treatment of depression in children? -
ANSWER-Fluoxetine.
Fluoxetine and escitalopram for adolescents.
Which two SSRIs can prolong the QT interval? - ANSWER-Citalopram and
Escitalopram.
An increased risk of cardiovascular and other malformations has been reported in
infants born to mothers who took which SSRI in the first trimester? - ANSWER-
Paroxetine.
,The adverse effects of SNRIs is very similar to that of SSRIs, but there are three
common additional adverse effects of SNRIs - what are they? - ANSWER--
Diaphoresis
-Tachycardia
-Urinary retention
SNRIs can cause a dose-dependent increase in ___________________, which
should therefore be controlled before beginning an SNRI and monitored while
taking an SNRI. - ANSWER-Blood pressure
What are some contraindications to prescribing Bupropion? - ANSWER--*Seizure
disorders*
-Eating disorders *patients with eating disorders have had a higher incidence of
seizures when treated with high doses of bupropion.
Which antidepressant may be useful when insomnia and/or significant decreased
appetite is prominent? - ANSWER-Mirtazepine
Which drug is the treatment of choice for bipolar disorder? - ANSWER-Lithium
Which drugs are typically used for acute manic episodes of bipolar disorder? -
ANSWER--Second generation antipsychotics
-Lithium
-Valproate
Which psych med has been shown to have protective effects against suicide and
self-harm when used for treatment of bipolar depression? - ANSWER-Lithium
,Which drug class should not be used as monotherapy for treating depressive
bipolar? - ANSWER-SSRIs; they can precipitate mania and generally should be
used only as an adjunct to mood-stabilizing drugs such as lithium.
Which medications are often prescribed with lithium to treat bipolar disorder, and
help reduce the risk of both manic episodes and depressive episodes? - ANSWER--
Second generation antipsychotics
-Valproate
-Carbamazepine
-Lamotrigine
Name some long-term adverse effects of lithium. - ANSWER--Hypothyroidism
-Kidney damage
-Hypercalcemia
-Leukocytosis
-Severe acne
-Psoriasis (induction or exacerbation)
What are some signs/symptoms of lithium toxicity? - ANSWER-Picture a drunk
person:
-Ataxia
-Slurred speech
-Confusion
-Vomiting
-Lethargy'
, -Tremor
Get a serum lithium level!
Which labs should be monitored regularly for patients on lithium? - ANSWER--
TSH
-BUN/Creatinine
-Lithium levels
Every 6-12 months in stable patients.
Which second generation antipsychotic has the lowest risk of causing
extrapyramidal symptoms? - ANSWER-Quetiapine
Which two mood stabilizers are associated with Stevens-Johnson Syndrome? -
ANSWER-Carbamazepine and Lamotrigine.
What is the safest antipsychotic to use on pregnant patients? - ANSWER-
Lurasidone
Which mood stabilizer is safest to use on pregnant patients? - ANSWER-
Lamotrigine
Which medication if combined with SSRIs, increases the risk of seizures? -
ANSWER-Tramadol (Altram)