12973931
Beschreibung
Quiz von Melanie Grynsztejn, aktualisiert more than 1 year ago
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Erstellt von Melanie Grynsztejn
vor mehr als 6 Jahre
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Frage 1
Frage
The following are early onset EPS symptoms
Antworten
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskensia
Frage 2
Frage
Which EPS symtom can appear within days
Antworten
-
Dystonia
-
Akatsia
-
Parkinsonism
-
Tardive dyskinesia
Frage 3
Frage
Which EPS symptom can appear within weeks?
Antworten
-
Dystonia
-
Akathisia
-
Parkinsonsism
-
Tardive dyskenia
Frage 4
Frage
Which EPS symptom can appear within months?
Antworten
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskinesia
Frage 5
Frage
Which EPS symtoms can take years to appear?
Antworten
-
Dystonia
-
Akathisia
-
Parkinsonism
-
Tardive dyskensia
Frage 6
Frage
Types of drug-induced movement disorders:
[blank_start]Acute:[blank_end] Occur within a short duration of treatment onset or dose increase
[blank_start]Chronic:[blank_end] Symptoms persist throughout treatment
[blank_start]Tardive[blank_end]: Delayed onset of symptoms
[blank_start]Withdrawal:[blank_end] Occur in the absence of treatment. May resolve
Antworten
-
Acute:
-
Withdrawal:
-
Chronic:
-
Tardive
-
Tardive
-
Withdrawal
-
Withdrawal:
-
Tardive
Frage 7
Frage
Dopamine system pathways include:
Mesolimbic: arousal, memory, behavior
Mesocortical: cognition, socializaiont
Tuberoinfundibular: regulation of prolactin
Nigrostriatal: modulation of EPS
Antworten
- True
- False
Frage 8
Antworten
-
Dopamine deficiency in the basal ganglia and striatum
-
Overactive cholinergic system
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens
-
Blockade of the striatal dopamine receptors
Frage 9
Frage
What are risk factors for dystonia
Antworten
-
Young age
-
H/O ECT
-
Male gender
-
High potency neuroleptics - Haldol, Prolixin
-
Comorbid medical conditions
Frage 10
Antworten
-
Opisthotonos
-
Blepharospasm
-
Torticollis
-
Oculogyric crisis
-
Oro-mandibular
Frage 11
Frage
The MOA for akathisia, from the Greek meaning "inability to sit", is:
Antworten
-
Dopamine deficiency in the basal ganglia and striatum
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens, Overstimulation of locus coeruleus.
-
Blockade of the striatal dopamine receptors
-
Striatal dopaminergic hypersensitivity
Frage 12
Frage
Which of the following agents cause akathisia
Antworten
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SSRI
-
Second generation antipsychotics
-
Antiemetics
-
CCB
-
Anti-anxiolytics
Frage 13
Frage
What are some differentials for akathisia
Antworten
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GAD
-
ADHD
-
Agitation
-
MDD
Frage 14
Frage
What are clinical presentation of akathisia
Antworten
-
Restlessness
-
Breaking out into song & dance for no reason
-
Fidgety movements/leg swinging
-
Marching in place
-
Rocking from one foot to another
-
Picking
Frage 15
Frage
The risk factors for akathisia include
Antworten
-
Advanced age
-
Affective disorder
-
Cognitive impairment
-
Female impersonator performer
-
Female
-
H/O akathisia
-
Iron deficiency
-
High dose/potency/neuroleptics
Frage 16
Frage
Pathophysiology of pseudoparkinsonism is:
Antworten
-
Dopamine deficiency in the basal ganglia and striatum
-
Dopaminergic/serotonergic or dopaminergic/cholinergic imbalance in the nucleus accumbens
-
Blockade of the striatal dopamine receptors and depletion of pre-synaptic celft
-
Striatal dopaminergic hypersensitivity and cholinergic deficiency in the basal ganglia
Frage 17
Frage
Parkinsonism = [blank_start]bradykesia[blank_end]
Pseudoparkinsonism = [blank_start]apraxic slowness[blank_end]
Antworten
-
bradykesia
-
apraxic slowness
-
bradykinesia
-
apraxic slowness
Frage 18
Frage
Parkinsonism = [blank_start]resting tremor[blank_end]
Pseudoparkinsonism = [blank_start]essential tremor, myoclonus[blank_end]
Antworten
-
resting tremor
-
essential tremor, myoclonus
-
resting tremor
-
essential tremor, myoclonus
Frage 19
Frage
Parkinsonism = [blank_start]lead pipe rigidity[blank_end]
Pseudoparkinsonism = [blank_start]paratonic rigidity[blank_end]
Antworten
-
lead pipe rigidity
-
paratonic rigidity
-
lead pipe rigidity
-
paratonic rigidity
Frage 20
Frage
Parkinsonism = [blank_start]postural instability[blank_end]
Pseudoparkinsonism = [blank_start]frontal ataxia[blank_end]
Antworten
-
postural instability
-
frontal ataxia
-
postural instability
-
frontal ataxia
Frage 21
Frage
Parkinsonism = [blank_start]Slow, shuffling gait with festination[blank_end]
Pseudoparkinsonism = [blank_start]Slow, shuffling apraxic gait[blank_end]
Antworten
-
Slow, shuffling gait with festination
-
Slow, shuffling apraxic gait
-
Slow, shuffling gait with festination
-
Slow, shuffling apraxic gait
Frage 22
Frage
What are risk factors for pseudoparkinsonism?
Antworten
-
Female
-
Male
-
Advanced age
-
Central DA receptor binding agents, Metclopramide, phenothiazines
-
AIDS
-
Cancer
Frage 23
Frage
Tardive dyskinesia
Antworten
-
If identified early can be reversed
-
is not reversible
-
increased risk with increased use
-
increased use does not cause increases risk
-
early onset
-
late onset
Frage 24
Frage
MOA for tardive dyskinesia
Antworten
-
Striatal dopaminergic hypersensitivity
-
Cholinergic deficiency within basal ganglia
-
Oxidative stress and cell injur
-
Genetic susceptibility
-
Glutamate-induced excitotoxicity
-
GABA mediated neuronal dysfunction
-
Blockade of the striatal dopamine receptors
Frage 25
Frage
Which medications most commonly cause tardive dyskinesia?
Antworten
-
Meoclopramide
-
Alpha adrenergic agonists
-
SGA
-
FGA
Frage 26
Frage
Clinical presention of tardive dyskinesia
Antworten
-
Choreiform - characterized by jerky, involuntary movements, chiefly of the face and extremitiesImage:Chorea (binary/octet-stream)
-
Athetoid - characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue
-
Stereotypic - petitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury.
Frage 27
Frage
EPS can be caused by antiemetics, antieliptics, psychotropics, cardiovascular agents and Levodopa
Antworten
- True
- False
Frage 28
Frage
EPS can be caused by antiemetics, antieliptics, psychotropics, cardiovascular agents and Levodopa
Antworten
- True
- False
Frage 29
Frage
The following drugs cause all four movement disorders: dystonia, akathisia, Parkinsonism, tardive dyskinesia
Antworten
-
Metoclopramide
-
Prochloraperazine
-
Amoxapine
-
Neuroleptics
-
SSRI
-
Levodopa
Frage 30
Frage
How often should the Abnormal Involuntary Movement Scale (AIMS) be administered?
Antworten
-
Baseline then every week x4 then every 3 months
-
Baseline then every week x2 then every 12 months
-
Baseline then every week x2 then every 6 months
Frage 31
Frage
What are overall tips for treatment of EPS?
Antworten
-
Stop offending agen (if possible)
-
Reduce the dose
-
Switch to a second generation antipsychotic
-
Treat prophylactically
-
A wing and prayer and refer to anyone else
Frage 32
Frage
Dystonia put in order of line of treatment
First line = [blank_start]anticholinergic agents[blank_end]
Second line = [blank_start]Baclofen[blank_end]
Third line = [blank_start]Benzo[blank_end]
Fourth line - [blank_start]Botox[blank_end]
Antworten
-
anticholinergic agents
-
Baclofen
-
Benzo
-
Botox
Frage 33
Antworten
- True
- False
Frage 34
Frage
Drug of choice for dystonia is
Antworten
-
Beta-blockers, anticholinergics, benzodiazepines, 5-HT2A receptor antagonist, mirtazapine
-
Anticholinergics (benztropine, diphenhydramine, trihexyphenidyl)
-
Clonzaepam, ginkgo biloba
Frage 35
Frage
Drugs of choice for akathisia include
Antworten
-
Anticholinergics (benztropine, diphenhydramine, trihexyphenidyl)
-
Beta-blockers, benzodiazepines, 5-HT2A receptor antagonist, mirtazapine
-
Clonazepam, ginkgo biloba
Frage 36
Frage
Mirtazapine (Remeron)
Antworten
-
Used in low doses to treat akathisa
-
Used in low doses to treat dystonia
-
Alpha-adrenergic receptor antagonist
-
Alpha-adrenergic receptor agonist
-
Antagonizes 5-HT2 and 3 receptors
Frage 37
Antworten
- True
- False
Frage 38
Frage
Which drugs are used to treat pseudoparkinsonism?
Antworten
-
Cogentin (benztropine)
-
Symmetrel (amantadine)
-
Benzodiazepines
-
Mirtazapine (Remeron)
-
Diphenhydramine (Benadryl)
Frage 39
Frage
MOA for amantadine (Symmetrel) is
Antworten
-
Dopamine agonist
-
Dopamine antagonist
-
5-HT2 agonist
-
5-HT2 antagonist
Frage 40
Frage
Side effects for benztropine (Cogentin) include
Antworten
-
Dry mouth
-
Hypotension
-
Diarrhea
-
Constipation
-
Cognitive impairment
-
Sialorrhea
Frage 41
Frage
Side effects for amantadine (Symmetrel) include:
Antworten
-
Hypotension
-
Hypertension
-
Agitation
-
Sedation
-
Worsening s/s of psychosis
Frage 42
Frage
Which drugs are used in the treatment of tardive dyskinesia
Antworten
-
Diltiazem
-
Baclofen
-
Galantamine
-
Clonazepam
-
Ginkgo biloba
Frage 43
Frage
What is the first FDA approved medication for Tardive Dyskinesia
Antworten
-
Velbeazine (Ingrezza)
-
Benztropine (Cogentin)
-
Trihexphenidyl (Artane)
-
Amantadine (Symmetrel)
Frage 44
Frage
What is the MOA for valbenazine (Ingrezza)?
Antworten
-
Blocks alpha-adrenergic receptors and antagonizes 5-HT2 and 3 receptors
-
Reversible inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release
-
Increase in synthesis and release of dopamine, and inhibition of dopamine uptake.
-
Selective M1 muscarinic acetylcholine receptor antagonist. It is able to discriminate between the M1 (cortical or neuronal) and the peripheral muscarinic subtypes (cardiac and glandular)
Frage 45
Frage
Acute [blank_start]laryngeal[blank_end] dystonia is considered a medical emergency.
Must seek treatment immediately. May require IV diphenhydramine
Antworten
-
laryngeal
Frage 46
Frage
Velbenazine is extensively metabolized by hydrolysis to form active metabolite
and by oxidative metabolism to form mono-oxidized valbenazine and other minor metabolites
Antworten
- True
- False
Frage 47
Frage
High fat meals may [blank_start]decrease[blank_end] absorption of valbenazine (Ingrezza)
Antworten
-
decrease
-
increase
Frage 48
Frage
Common adverse side effects of valbenazine (Ingrezza) include:
Antworten
-
Fatigue
-
HA
-
Constipation
-
Diarrhea
-
UTI
-
Somnolence
Frage 49
Frage
Warnings for valbenazine (Ingrezza) include:
Antworten
-
Somnolence
-
QTc prolongation
-
Pregnancy/breastfeeding
-
Hypertension
Frage 50
Frage
Valbenazine should not be used in:
Antworten
-
Severe renal impairment (< 30 mL/min)
-
CHF
-
Cirrhosis
-
Pancreatitis
Frage 51
Frage
Strong 3A4/2D6 inhibitors: [blank_start]Increase[blank_end] valbenazine concentration
Strong 3A4 inducer: [blank_start]Decrease[blank_end] valbenazine concentration
Antworten
-
Increase
-
Decrease
-
Increase
-
Decrease
Frage 52
Frage
Valbenazine (Ingrezza) interacts with MAOIs by [blank_start]increasing[blank_end] the monamine NT in the synapse
Antworten
-
increasing
-
decreasing
Frage 53
Frage
Valbenazine (Ingrezza) interacts with digoxin and [blank_start]increase[blank_end]s the digoxin concentration by p-glycoprotein [blank_start]inhibtion[blank_end]
Antworten
-
increase
-
decreases
-
inhibtion
-
inducer
Frage 54
Frage
Deutetrabenazine (Austedo) is used for the treatment of chorea and schizophrenia/schizoaffective disorder. It is metabolized by CYP2D6
Antworten
- True
- False
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