Which of the following describe SSRI's?
Block reuptake of serotonin into the presynaptic terminal
Very selective with few/less bothersome side effects
Least sedative effect
Decrease serotonin and norepinephrine without an appreciable effect on dopamine
Drug of choice with major depression
Highest potential for OD in the anti-depressants
Used to treat depression
Dangerous if taken with foods that contain tyramine (processed meats, pork, alcohol, chocolate)
Which of the following describe SNRI's?
May be used for chronic pain
Not very selective, has more interactions with other drugs
Directly increase activity at amine synapses
Which of the following describe Tricyclics?
Block the reuptake of amine neurotransmitters into the presynaptic terminal
Not the drug of choice for depression; higher incidence of side effects
Which of the following describe MAO Inhibitors?
With Serotonin Syndrome, serotonin accumulates in the brain causing sweating, agitation, restlessness, shivering, and tachycardia, leading to seizures, coma, or death.
Depression occurs when there is an excessive amount of one (or more) of the amine neurotransmitters (serotonin, norepinephrine, and dopamine) in the CNS. Therefore, treatment for depression revolves around selective stripping of these neurotransmitters, one at a time.
Depression occurs when there is a lack of one of the amine neurotransmitters (serotonin, norepinephrine, and dopamine) .
Anti-depressant medications work to block the reuptake of the amines (SSRI, SNRI, Tricyclics) or increase the sensitivity of the amine receptors and block the destruction of the amines (MAO Inhibitors).
Select the common side effects of Tricyclics.
Sedation
Anticholinergic Effects
Orthostatic Hypotension
Dry Mouth
Confusion
Tachycardia
Sleep Loss
Restlessness
Weight Loss
Increased Seizure Activity
Nitroglycerin is used to treat Bi-Polar Disorder because it prevents the depressive phase of the disorder.
Lithium is used to treat Bi-Polar Disorder because it prevents the manic phase of the disorder.
Schizophrenia is triggered by a combination of which of the following?
Genetic Factors
Environmental Triggers (brain injury or social stress)
Disease
Age
Once triggered, Schizophrenia is caused by which of the following? **Updated**
Excessive dopamine synthesis and release by the presynaptic neuron
Decreased dopamine breakdown at the synapse
Increased postsynaptic dopamine receptor sensitivity
Overactivity of Serotonin
Increased dopamine transmission in areas such as the limbic system
Antipsychotic medications end in which of the following?
-azine
-apine
-idone
-olol
-ase
-am
Which of the following are advantages of using the newer antipsychotics (-apine, -idone) instead of the traditional medications (-azine)?
Decreased risk of motor side effects
Less incidence of relapse
Drugs don’t work long enough to cause receptor supersensitivity
No chance of orthostatic hypotension
Decreased risk of metabolic effects
Side effects for antipsychotice drugs include which of the following?
Extrapyramidal Symptoms (Tardive Dyskinesia)
Photosensitivity
Metabolic Effects
GI Syndromes (Nausea, Vomiting, etc)
Serotonin Syndrome
Addiction
Anterograde Amnesia
Which of the following are Extrapyramidal Side Effects?
Acute Dystonic Reactions
Akathisia
Pseudo-Parkinsonism
Tardive Dyskinesia
Neuroleptic Malignant Syndrome
Blurred Vision
Constipation
Urinary Retention
Rigidity
Which of the following are Anticholinergic Side Effects?
Dyskinesia
Apathy
Nausea
Chorea
Which of the following best describes Status Epilepticus?
A medical emergency due to a state of Continuous Seizures.
Medical term for a patient with epilepsy.
Medical term for a patient who was previously epileptic, but is no longer.
A patient who has epilepsy, but has not had a seizure.
What are the criteria for withdrawal from an anti-epileptic drug?
Seizure-free for 2 years, good control for 1 year after medication began
Normal neurological exam
Initial seizure onset during childhood
Normal neurological exam for 3 years in a row
Initial seizure onset during adulthood
Seizure-free for 1 year, good control for 6 months after medication began
Seizure-free for 5 years, good control for 3 years after medication began
While working in an inpatient setting, you are given a patient with epilepsy. In order to minimize the seizure risk during therapy, which of the following is most appropriate?
Perform therapy in the patient's room rather than the therapy department, in order to minimize visual and audible stimuli.
Perform therapy at the same time every day.
Perform therapy right before the patient eats a meal.
Have a therapy tech on hand to help catch the patient in case they fall.
Which of the following are true regarding carbidopa?
Carbidopa inhibits the premature breakdown of levodopa
Allows for a lower dosage of levodopa
Carbidopa is the gold standard for Parkinson's medications
Carbidopa is a precursor to dopamine
Which of the following are side effects of Sinemet?
GI Problems
Depression
Anxiety
Weight Gain
Hypertension
Sinemet contains which of the following?
Dopamine
Levodopa
Carbidopa
Order the Stages of General Anesthesia: 1.) ❌ 2.) ❌ 3.) ❌ 4.) ❌
Of the following General Anesthetics, which are administered via inhalation?
Nitrous oxide
Halothane
Desflurane
Barbiturates
Benzodiazepines
Opiods
Dexmedetomidine
Etomidate
Propofol
Of the following General Anesthetics, which are administered via intravenous injection?
Nitrous Oxide
Volatile Liquids
Why do General Anesthetics have a hangover effect?
They are generally administered with a shot of tequila.
They are very lipid soluble and some wind up stored in adipose tissue for a bit.
General Anesthetics do not have a hangover effect.
Adjuvants may be administered with a general anesthetic to provide additional effects, such as sedation/relaxation and neuromuscular blocking.
Local anesthetics end in which of the following suffixes?
-caine
-caide
-dine
Why is epinephrine commonly administered with local anesthetics?
The vasoconstrictive ability of epinephrine limits the distribution of the drug, thus avoiding the toxic effect which occurs when too much of the drug reaches systemic circulation.
Epinephrine increases HR, thus limiting the amount of time the drug stays in one place which can cause necrosis.
Epinephrine is not commonly administered with a local anesthetic. You are thinking of Norepinephrine.
Many patients are allergic to local anesthetics, so administering epinephrine prior to the local anesthetic minimizes the chance of an allergic reaction.
What is a Bier Block?
Intravenous (IV) injection of local anesthetic into an arm or leg to block the limb.
Injection of local anesthetic into the sympathetic chain ganglion for CRPS.
Injection of local anesthetic for a spinal nerve block (aka epidural).
Heating modalities accelerate transdermal absorption of local anesthetics. Thus, applying moist heat before beginning ROM components of therapy is beneficial because it will help the patient stretch further.
2 classifications of postsynaptic receptors based on NTs
❌ receptor: acetylcholine, targets parasympathetic nervous system and some sympathetic. Increase activity at synapses.
❌ receptor: norepinephrine, targets sympathetic nervous system. Diminish response of tissues.
Cholinergic Drugs can be used to treat which of the following?
Alzheimer's Disease
Glaucoma
Myasthenia Gravis
Parkinon's Disease
Irritable Bowel Syndrome
Motion Sickness
Anti-Cholinergic Drugs can be used to treat which of the following?
Parkinson's Disease
Which of the following are side effects of cholinergic drugs?
Salivation
Lacrimation
Urination
Diarrhea
GI Cramps
Emesis
Vasodilation
Delirium
Blurred vision
Which of the following are side effects of anti-cholinergic drugs?
Decreased sweat
Dry mouth
Urinary retention
CNS delirium
❌ inhibit response to adrenaline/epinephrine/norepinephrine which decreases sympathetic response. ❌ stimulate response to adrenaline/epinephrine/norepinephrine which increases sympathetic response. ❌ increase activity at synapses which increases parasympathetic responses. ❌ decrease activity at synapses which decreases parasympathetic responses.
Which of the following adrenergic drugs do the following? Vasoconstrict smooth muscle thus increase BP
Alpha-1 Selective Agonists
Alpha-2 Selective Agonists
Beta-1 Selective Agonists
Beta-2 Selective Agonists
Alpha Antagonists
Beta Blockers
Which of the following adrenergic drugs do the following? Inhibit Sympathetic Discharge (brain and spinal cord)
Which of the following adrenergic drugs do the following? Increase HR and CO
Which of the following adrenergic drugs do the following? Relaxation of smooth muscle
Which of the following adrenergic drugs do the following? Reduce peripheral vascular tone
Which of the following adrenergic drugs do the following? Decrease HR/contraction force
