Term
| With the use of SSRIs, what is the major SE? |
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Definition
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Term
| If a pt is on fluoxetine and the pt has noted mental changes, muscle stiffness, and hyperthermia sx, what condition should you suspect? |
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Definition
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Term
| Which meds are contraindicated when using SSRIs? What may result from a combo of these drugs? |
|
Definition
| MAOIs; Serotonin Syndrome |
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Term
| Which anti-depressant drug inhibits the cyp P-450 system and can enhance the effects of several drugs including tricyclic anti-depressants, haloperidol and some anti-arrhythmic meds? |
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Definition
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Term
| Which meds are contraindicated for concurrent use with TCAs? Why? |
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Definition
| MAOIs; can lead to seizures |
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Term
| Which anti-depressants with overdose can lead to Quinidine like effects including prolonged QT, ventricular arrhythmias, and torsades de pointes? |
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Definition
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Term
| What is the tx for TCA overdose? |
|
Definition
Sodium Bicarb (systemic alkalization),
high dose pressors,
Phenytoin or Benzos (suppress seizures),
Prolonged CPR |
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Term
| Which third-generation anti-depressant med (or heterocyclic anti-depressant) causes increases in BP and HR (at high doses > 225mg/day)? |
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Definition
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Term
| Which third generation anti-depressant causes less sexual dysfunction than SSRIs? |
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Definition
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|
Term
| Which SSRI has the least amount of sexual dysfunction? |
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Definition
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|
Term
| Which 2 SSRIs are potent inhibitors of the CYP systems? |
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Definition
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Term
| Which anti-depressant med has a low risk of fatality with overdose? |
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Definition
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Term
| What dietary considerations are necessary when taking MAOIs? What will happen if these precautions are not taken? |
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Definition
| Avoid tyramine containing foods including wine, smoked cheese and meat. Can lead to a HTN crisis |
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|
Term
| Which drugs interact with MAOIs? |
|
Definition
TCAs and other anti-depressants
Dextromethorphan
Tramadol
Sympathomimetics |
|
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Term
| If a pt on Tranylcypramine for their phobia disorder presents with agitation, delirium, neuromuscular ecitability, obtunded conciousness, and hyperthermia, what condition do you suspect? How do you treat it? |
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Definition
| Overdose; Tx with supportive care |
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Term
| Which anti-depressant med causes sedation (due to its histamine blockade), postural HTN, urinary retention, dry mouth, and priapism? |
|
Definition
| TCAs - (priapism is specifically a SE of trazodone use) |
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Term
| Which anti-depressant med leads to EKG changes including widened QRS complex, arrhythmias, as well mental status changes, and seizures with overdose? |
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Definition
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|
Term
| Which heterocyclic anti-depressant cause an increased appetite and weight gain as a SE? |
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Definition
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|
Term
| Which Heterocyclic anti-depressant causes elevated BP and HR as a side-effect? |
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Definition
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|
Term
| Which med used as a mood stabilizer cannot be used during pregnancy, as it is a teratogen? |
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Definition
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|
Term
| What monitoring needs to be done for a pt on lithium? why? |
|
Definition
| Serum levels of lithium must be monitored due to its narrow therapeutic window of the drug and thus the increased risk for lithium intoxication |
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|
Term
| Which med can cause a fine hand tremor, hypothyroidism, nephrogenic diabetes insipidus (presents with hypernatremia, polyuria and polydipsia) as well as ECG changes and edema? |
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Definition
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|
Term
| Which med used to treat the pos sx of schizophrenia can cause sedation, anticholinergic effects, Extrapyramidal symptoms, galactorrhea, amenorrhea, tardive dyskinesia, and akathisia (can't stay still)? |
|
Definition
| Typical Antipsychotics (haloperidol, Fluphenazine, Chlorpromazine, Thioridazine) |
|
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Term
| Which med can cause neuroleptic malignant syndrome? What are the symptoms of this syndrome? |
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Definition
| Typical Antipsychotics (haloperidol, fluphenazine, chlorpromazine, thioridazine); Characterized by muscle rigidity, a change in mental status, elevated temp and autonomic instability |
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|
Term
| If a pt presents with muscle rigidity, a change in mental status, elevated temp and autonomic instability, and a medication hx of taking fluphenazine, what condition does this pt have and how can it be treated? |
|
Definition
| Pt has Neuroleptic Malignant Syndrome; Can be tx with Dantrolene (a muscle relaxant) and dopamine agonists |
|
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Term
| Which meds have more extrapyramidal and anticholinergic side effects, atypical or typical anti-psycotics? |
|
Definition
| Atypical have less of these side effects |
|
|
Term
| Which med can cause mild leukopenia and agranulocytosis? |
|
Definition
| Clozapine (an atypical anti-psycotic) |
|
|
Term
| If a pt reports to the ER with altered mental status, anxiety, tachycardia, and vomiting and you have noted that they have been taking a med for their status epilepticus seizures, what med are they on and what condition do you suspect? |
|
Definition
| They are on a Benzo and have stopped taking it abruptly and are experiencing withdrawl symptoms. |
|
|
Term
| What is a Benzo overdose characterized by? How is an overdose treated? |
|
Definition
| Cardiac and Respiratory depression; Treated with Flumezenil (competitive antagonist of Benzos at the GABA receptor) |
|
|
Term
| In which pts should Benzos be avoided? |
|
Definition
| Avoided in pts with liver dx, pts who use CNS depressants (such as alcohol, or barbituates) |
|
|
Term
| Can barbiturates be used in pregnant women? |
|
Definition
|
|
Term
| What are the SE of Barbiturates? |
|
Definition
| Nausea, Sedation, Teratogen |
|
|
Term
| If a pt presents with cardiac and respiratory depression after a hx of phenobarbital use to treat seizures, what condition should you suspect and how do you treat it? |
|
Definition
| Barbiturate OD; Tx with Mechanical ventilation, hemodialysis, and alkalinization of urine |
|
|
Term
| In which pts should barbiturate use be avoided? |
|
Definition
Prego women
Pts with Liver disease
Pts with porphyria
Pts using alcohol, Benzos or other CNS Depressants |
|
|
Term
| What are the withdrawal symptoms of barbiturates? |
|
Definition
| Nausea, Anxiety, Seizures, Tachycardia, |
|
|
Term
| Because Barbiturates affect the CYP-450 system, which meds are affected and what is the effect? |
|
Definition
| It induces the CYP-450 system causing DECREASED levels of several drugs including DIGITALIS, PHENYTOIN, and GRISEOFULVIN |
|
|
Term
| Which med that is used to treat simple and complex partial seizures and generalized tonic/clonic seizures has SE including severe rash, HA and nausea? |
|
Definition
|
|
Term
| Which seizure med causes SE including Nystagmus, gingival hyperplasia, drug-induced lupus and is teratogenic (causing fetal hydantoin syndrome)? |
|
Definition
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|
Term
| Which anti-seizure med is teratogenic, causing neural tube defects and is also hepatotoxic to the pt? |
|
Definition
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|
Term
| Carbamazepine has effects on the CYP-450 system, what are its affects and what meds are involved? |
|
Definition
| Induces the CYP-450 system which causes a decrease in the level of certain anti-epileptic meds (eg phenytoin) |
|
|
Term
| Which anti-epileptic can cause SE including hepatotoxicity, agranulocytosis, aplastic anemia as well as GI symptoms, double vision, and dizziness? |
|
Definition
| Carbamazepine, Oxcarbazepine |
|
|
Term
| Which med is similar to Tiagabine but works by inhibiting the breakdown of GABA and has SE including sedation and psychiatric disturbances? |
|
Definition
|
|
Term
| What electrolyte imbalance can be caused by Succinylcholine? |
|
Definition
|
|
Term
| What severe life-threatening SE can be caused by the administration of Succinylcholine? How can its effects be reversed? |
|
Definition
Cardiac Arrhythmias and bradycardia
Reversible by Physostigmine |
|
|
Term
| What med if administered with succinylcholine can cause malignant hyperthermia? What are the Symptoms of malignant hyperthermia? How is it treated? |
|
Definition
Halothane;
Sx - Muscle rigidity and elevated body temp;
Tx - Dantrolene |
|
|
Term
| Which med is used to reverse malignant hyperthermia by inhibiting the release of Ca from the sarcoplasmic reticulum of myocytes thereby decreasing muscle contractions? |
|
Definition
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|
Term
| What anesthetic med can lead to SE including Hypotension, tachycardia, and prolonged respiratory depression? How can its effects be reversed? |
|
Definition
Pancuronium
Reversed by administering a cholinesterase inhibitor (eg - neostigmine) |
|
|
Term
| Which local anesthetic is associated with myocardial depression and hypotension? |
|
Definition
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|
Term
| Which local anesthetic is associated with HTN and cardiac arrhythmias? |
|
Definition
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|
Term
| What med used in minor surgical procedures can cause a SE of seizures? |
|
Definition
|
|
Term
| What do all of the general anesthetics cause as major SE? |
|
Definition
| Respiratory and Myocardial depression |
|
|
Term
| Which General Inhaled Anesthetic causes fulminant hepatic necrosis and cardiac arrhythmias? |
|
Definition
|
|
Term
| Which two general Inhaled anesthetics cause nephrotoxicity? |
|
Definition
| Methoxyflurane and Enflurane |
|
|
Term
| Which general IV anesthetic agent is rarely used due to its side effect profile including hallucinations and cardiac and respiratory depressant? |
|
Definition
|
|
Term
| Which general IV anesthetic agent has SE including hypotension and chemical pancreatitis? |
|
Definition
|
|
Term
| Which general IV anesthetic agent has SE including vomiting, myoclonus, and adrenal suppression? |
|
Definition
|
|
Term
| What are the major SE of opioids? |
|
Definition
| Cardiac and respiratory depression and constipation |
|
|
Term
| Which med is used to treat an opioid overdose? |
|
Definition
|
|
Term
| In which pts should Dextromethorphan NOT be used in? |
|
Definition
| Can cause death in children under 6 y/o |
|
|
Term
| What are the major SE of Levodopa? |
|
Definition
| Tardive Dyskinesia and Cardiac Arrhythmias |
|
|
Term
| In which pts is Sumatriptan contraindicated in? Why? |
|
Definition
| Pts with CAD; Results in coronary vasospasm |
|
|
Term
| What are some major SE of Bupropion? |
|
Definition
| Psychosis, seizures, dry mouth |
|
|
Term
| If a pt reports to the clinic with suicidal ideations, and reports of hallucinations, and the wife explains the doc put him on meds to help him quit smoking, what med do you suspect is the cause of this psychosis? |
|
Definition
|
|
Term
| What are the SE of Buspirone? |
|
Definition
| Dizziness, Insomnia, Nausea |
|
|
Term
| Which med whose MOA is a GABA analogue has SE of peripheral edema, sedation and hepatotoxicity? |
|
Definition
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