Pharm exam 3 blk 7 part 2

sbentley's version from 2016-02-19 03:06


Question Answer
inhibits cAMP (chromosome 11) blocks Ca++ channels but opens K+ channels found pre- and post-synaptically in the striatum and olf. tubercle. DA2
in same family, decrease cAMP, G-protein linked. DA3 in cortex, medulla and midbrain. DA3 and DA4
Features = oral-facial dyskinesia; widespread choreo-athetosis or dystonia. o Time of risk = after months or years of treatment (worse on withdrawal) o Mechanism = excess function of dopamine hypothesized. o Treatment = prevention is crucial because treatment is unsatisfactoryTardive Dyskenesia
increased prolactin, infertility, amenorrhea, galactorrheaEndocrine AE of Antipsychotics
level of movement side-effects from sertindole equal to placebo
Give two side-effect issues with olanzapineweight gain, some extrapyramidal side effects and tardive dyskinesia, no agranulocytosis, some elevation of prolactin
less incidence of glucose intolerance and weight gainTypical anti-psychotics
more incidence of glucose intolerance (hyperglycemia, glucosuria, diabetes) and weight gain (except risperidone) Atypical anti-psychotics
4 ways to avoid weight gain in pts on antipsychoticsmonitor weight, fasting blood glucose, and serum concentrations of lipids and insulin. • 2) Where possible use atypical antipsychotics with lower levels of weight gain (see above) • 3) Use lowest effective dose of anti-psychotic, • 4) regularly ask patients taking atypicals with higher incidence of weight gain about diabetic symptoms, weight, lethargy, polydipsia etc.
two anti-psychotics that when given long-term demonstrate dangerous changes in the QT interval Clozapine, olanzapine
advantage of using lithium in treatment of mood disorders in alcoholicsAlcoholism is often associated with bipolar, and lithium reduces drinking when the conditions coexist
What do you do in a lithium OD?Stop the Lithium and monitor serum levels. 2.Use hemodialysis to remove
Why is lithium contraindicated in cases of “sick sinus”.Bradycardia-tachyardia (“sick sinus”) syndrome is a definite contraindication to use of lithium because Lithium further depresses the sinus node.

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