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Psychotropics

Total questions: 27

Worksheet time: 14mins

Name
Class
Date
1.

What property about fluoxetine makes it quite activating compared to other SSRIs?

a)

5HT2C antagonism

b)

Dopamine transporter inhibition

c)

sigma 1 binding

d)

5HT1A binding

2.

Which of the following SSRIs has the most potent interaction at sigma 1 receptor sites, thus allowing for more optimal anxiolysis? (Also helps most with psychotic depression)

a)

Sertraline

b)

Paroxetine

c)

Fluoxetine

d)

Fluvoxamine

3.

Which of the following combos is known as "California rocket fuel"?

a)

Sertraline + Wellbutrin

b)

Fluoxetine + Olanzapine

c)

Duloxetine + Amytriptiline

d)

Venlafaxine + Mirtazapine

4.

Alcohol has what effect on GABA and glutamate in the VTA?

a)

Increases GABA and decreases glutamate

b)

Increases both GABA and glutamate

c)

Decreases GABA and increases glutamate

d)

Decreases both GABA and glutamate

5.

Which of the following is a key agonist binding site for hallucinogens?

a)

Cannabinoid 1 receptors

b)

5HT2C receptors

c)

5HT2A receptors

d)

GABA-A receptors

6.

Which of the following is true regarding the affinity of a majority of the atypical antipsychotics?

a)

Higher affinity for D2 receptors than 5HT2A receptors

b)

Higher affinity for 5HT2A receptors than D2 receptors

c)

Comparable affinity for both D2 & 5HT2A receptors

d)

wtf brah

7.

How do you switch from a done to a pine?

a)

Taper down the done for a week while up-titrating the pine over 2 weeks

b)

Taper down the done for 2 weeks while up-titrating the pine for 1 week

c)

maintain the dose of the done while up-titrating the pine, and then start to taper down the done

d)

Taper down the done for a week while up-titrating the pine over 1 week

8.

What are the benefits of brexipiprazole over aripiprazole?

a)

Brexipiprazole = higher antipsychotic properties

b)

Brexipiprazole = Less EPS

c)

Brexipiprazole = more favorable metabolic profile

d)

Brexipiprazole = less sedating

9.

What does alpha 2 antagonism do to seratonin & norepinephrine?

a)

Increase NE and no effect on 5HT

b)

Increase 5HT and no effect on NE

c)

Increase both

d)

No effect on both

10.

Which of the following is the most potent property of trazodone?

a)

5HT2C antagonism

b)

5HT1A antagonism

c)

5HT2A antagonism

d)

Serotonin Reuptake Inhibition

11.

One must wait at least ___ half-lives after discontinuing a serotonergic drug before starting a MAO inhibitor

a)

3

b)

4

c)

5

d)

6

e)

7

12.

Which of the following TCA's should absolutely never be used with MAO inhibitors?

a)

Clomipramine

b)

Amitryptyline

c)

Nortriptyline

d)

Doxepin

e)

Imipramine

13.

Which class of antidepressants works better in women in the presence of estrogen? (i.e. more effective in pre-menopausal women than post-menopausal)

a)

SSRIs

b)

SNRIs

14.

Vilazodone combines serotonin re-uptake inhibition with which second property?

a)

NE re-uptake inhibition

b)

5HT2C antagonism

c)

Dopamine re-uptake inhibition

d)

5HT1A partial agonism

15.

Which antipsychotic must be given sublingually due to poor bioavailability if swallowed?

4 lines
16.

What is the blackbox warning of Risperidone?

a)

Increased suicidal thoughts in ages 12-29

b)

Increased chance of death in patients with dementia

c)

Increased risk of pancreatitis

d)

Increased risk of liver failure

17.

Olanzapine helps improve mood in treatment resistant depression especially when combined with which of the following?

a)

Venlafaxine

b)

Sertraline

c)

Escitalopram

d)

Fluoxetine

18.

What is the lowest effective dose of Quetiapine as an antipsychotic? (occupying 60% of D2 receptors)

a)

200 mg

b)

300 mg

c)

400 mg

d)

600 mg

19.

At what daily dose of seroquel have clinical trials repeatedly shown to demonstrate robust antidepressant effects?

a)

200 mg

b)

300 mg

c)

400 mg

d)

600 mg

20.

How do you switch from a done/pine to aripiprazole?

a)

Taper down the pip/done while starting abilify at low dose and titrating up slowly over 1-2 weeks

b)

Taper down the pip/done while starting abilify at a middle dose and quickly titrating up over a week

c)

Taper down the pip/done while starting abilify at the preferred maintenance dose, no titration necessary

21.

How do you switch from aripiprazole to a done/pine?

a)

Stop abilify right away, and start the pine/done at middle dose and up-titrate

b)

Taper down the abilify quickly over 1 week, while starting the pine/done at a middle dose and up-titrate

c)

Taper down abilify slowly between 1-2 weeks, while starting the pine/done at a low dose and up-titrate

d)

Stop the abilify right away, and start the pine/done at a low dose and up-titrate

22.

Which of the following SNRIs has more potent NE reuptake inhibition compared to seratonin reuptake inhibition? (Thus making it more useful for chronic pain conditions)

a)

Duloxetine

b)

Milnacipran

c)

Venlafaxine

d)

Desvenlafaxine

23.

Which of the following is the only FDA approved medication to treat pseudobulbar affect (The Joker)?

a)

Amlodipine

b)

Dextromethorphan

c)

Sertraline

d)

Nortriptyline

24.

Which of the following is true regarding the dosing of duloxetine for depression?

a)

Efficacy is dose-dependent, with greater response typically seen above 60 mg/day

b)

There is no evidence of increased efficacy above 60 mg daily, though, some patients may benefit from it

c)

The maximum dose is 60 mg per day due to significant increase in side effects at higher dose

d)

idk

25.

Which of the following is theoretically false regarding apathy?

a)

It can be a residual symptom of depression

b)

It can be a side effect of serotonergic antidepressants

c)

It is hypothetically due to elevated dopamine

d)

It is hypothetically due to elevated serotonin decreasing dopamine

26.

Which of the following is a reasonable approach to treating an aging patient with schizophrenia who then develops Alzheimer's dementia?

a)

Risks of cardiovascular events and death associated the Alzheimer's generally mean that antipsychotics should not be given even though the patient has long standing schizophrenia

b)

Generally the need for treating schizophrenia and the benefits of antipsychotic treatment of this condition outweigh the risks associated with antipsychotics when given in the presence of the additional condition of Alzheimer's disease

c)

Cholinesterase inhibitors alone reduce risk of mortality

d)

Behavioral modification alone has shown to beneficial to reduce all causes mortality compared with antipsychotic treatment

27.

If you want to add lamotrigine for a patient with a history of mood disorder who is currently on valproate, which of the following is the proper titration schedule?

a)

Valproate does not affect the plasma levels of lamotrigine, and therefore, no adjustments to titration schedule is needed

b)

Valproate increases the plasma level of lamotrigine, and thus the titration schedule should be halved

c)

Valproate decreases the plasma levels of lamotrigine and thus the titration schedule should be doubled

d)

Decrease dosage of Valproate during titration of lamotrigine