Medication Effects - Eppp Knowledge
- Which SSRI side effect is most associated with delayed orgasm or anorgasmia?
- Sexual dysfunction. SSRIs disrupt serotonin-mediated sexual function, leading to common complaints of arousal and orgasm difficulties.
- Which adverse effect cluster is most associated with high-potency typical antipsychotics like haloperidol?
- Extrapyramidal symptoms (EPS). High-potency agents strongly antagonize dopamine, disrupting basal ganglia function and causing movement disorders.
- What is the primary therapeutic effect of first-generation antipsychotics (typical antipsychotics)?
- Reduce positive symptoms of schizophrenia. Typical antipsychotics potently block D2 receptors, diminishing hallucinations and delusions in psychosis.
- Which clinical finding is most characteristic of lithium toxicity that should prompt urgent evaluation?
- Coarse tremor, ataxia, confusion, and GI upset. These neurotoxic signs indicate elevated serum levels, signaling potential progression to severe complications like seizures.
- Which antidepressant is most associated with hypertensive crisis when combined with tyramine foods?
- MAOIs (for example, phenelzine). MAOIs inhibit tyramine metabolism, causing norepinephrine surges that trigger hypertensive crises.
- Which atypical antipsychotic is most associated with metabolic syndrome (weight gain, diabetes risk)?
- Olanzapine. Olanzapine's receptor profile promotes insulin resistance and adiposity, elevating metabolic risks more than others.
- What adverse effect is most characteristic of paroxetine among SSRIs (relative to others)?
- Anticholinergic effects and weight gain. Paroxetine's stronger anticholinergic activity compared to other SSRIs causes these effects, making it distinct in the class.
- What is the life-threatening antipsychotic adverse reaction with fever, rigidity, and autonomic instability?
- Neuroleptic malignant syndrome (NMS). NMS arises from dopamine blockade, manifesting as hyperthermia and muscle breakdown in susceptible individuals.
- Which common medication class can raise lithium levels and increase toxicity risk?
- NSAIDs (also thiazide diuretics and ACE inhibitors). These drugs impair renal lithium clearance, elevating concentrations and toxicity risk through pharmacokinetic interaction.
- Which dangerous drug interaction increases risk of respiratory depression with benzodiazepines?
- Combination with opioids or alcohol. These CNS depressants synergistically suppress respiratory drive, heightening overdose potential.
- What is the dangerous interaction between SSRIs and MAOIs that requires a washout period?
- Serotonin syndrome risk. Concurrent use excessively elevates serotonin levels, precipitating this potentially fatal condition without adequate washout.
- Which antidepressant is most associated with weight gain and sedation due to antihistamine effects?
- Mirtazapine. Mirtazapine's H1 receptor antagonism promotes appetite and drowsiness, distinguishing it from other antidepressants.
- What is the classic triad of serotonin syndrome that should prompt urgent referral?
- Mental status changes, autonomic instability, neuromuscular hyperactivity. These symptoms reflect serotonin excess affecting CNS, autonomic, and motor systems, requiring immediate medical intervention.
- What is the primary therapeutic effect of benzodiazepines in psychiatric practice?
- Acute anxiolysis and sedation. Benzodiazepines enhance GABA activity, rapidly reducing anxiety and inducing calm in acute settings.
- What is the key adverse effect risk with long-term benzodiazepine use relevant to older adults?
- Falls, cognitive impairment, and dependence. Chronic use impairs balance and cognition while fostering tolerance, particularly hazardous in the elderly.
- Which SSRI is most associated with QT prolongation at higher doses (key EPPP safety point)?
- Citalopram. Citalopram prolongs the QT interval via dose-dependent effects on cardiac potassium channels, increasing arrhythmia risk.
- Which atypical antipsychotic requires ANC monitoring due to risk of agranulocytosis?
- Clozapine. Clozapine's unique myelosuppressive effect necessitates regular blood counts to prevent severe neutropenia.
- What is the primary therapeutic effect of lithium in bipolar disorder?
- Treat acute mania and prevent relapse. Lithium stabilizes mood by modulating intracellular signaling, effective for manic episodes and maintenance therapy.
- Which antidepressant is contraindicated in bulimia nervosa due to increased seizure risk?
- Bupropion. Bupropion lowers seizure threshold, exacerbating risks in eating disorders with electrolyte imbalances from purging.
- What is the most dangerous adverse effect of tricyclic antidepressant (TCA) overdose?
- Cardiac arrhythmias (QRS widening) and seizures. TCAs block sodium channels in overdose, causing conduction delays and convulsions that can be lethal.
- Which medication class has prominent anticholinergic side effects: dry mouth, constipation, urinary retention?
- Tricyclic antidepressants (TCAs). TCAs antagonize muscarinic receptors, leading to peripheral anticholinergic symptoms as a class hallmark.
- What is the primary therapeutic effect of SNRIs (for example, venlafaxine, duloxetine)?
- Treat depression/anxiety; also neuropathic pain. SNRIs block reuptake of serotonin and norepinephrine, alleviating symptoms in mood disorders and modulating pain pathways.
- Which SNRI adverse effect is especially associated with venlafaxine as dose increases?
- Increased blood pressure. Venlafaxine's noradrenergic effects intensify at higher doses, elevating sympathetic activity and blood pressure.