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Gurpal

Part II ISQ Club - Pharmacology

23 posts in this topic

Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

4 WEEKS LEFT UNTIL THE WRITTEN PAPERS! CLICK HERE FOR THE COUNTDOWN CLOCK!

1. DHEA has an effect opposite to the effects of cortisol

2. Clozapine should not be prescribed with carbemazepine

3. From the known binding properties of clozapine, it would be expected to cause little postural hypotension

4. Glutamate is a NMDA antagonist

5. Acamprosate is a NMDA antagonist

6. With NA-reuptake inhibitors, presynaptic alpha2 receptors are likely to be more sensitive to blockade

7. Giving nicotine to non-smoker volunteers increases attention

8. SSRIs may cause impotence

9. Bupronorphine is a GABA antagonist

10. Enalapril can increase plasma lithium levels

11. D5 receptors belong to the D1 family of receptors

12. Alpha waves are slowed in EEG by chronic benzodiazepine use

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1. DHEA has an effect opposite to the effects of cortisol

TRUE

“The beneficial effect of DHEA administration in depressed patients might result from its sigma 1 receptor-mediated enhancement of noradrenaline and serotonin neurotransmission, antiglucocorticoid effects, and cognition enhancing effects”

van Broekhoven & Verkes. Psychopharmacology (Berl). 2003 Jan;165(2):97-110. Epub 2002 Nov 06.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12420152&dopt=Abstract

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2. Clozapine should not be prescribed with Carbamazepine

TRUE

(Pg 1073, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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3. From the known binding properties of clozapine, it would be expected to cause little postural hypotension

FALSE

(Pg 1073, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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7. Giving nicotine to non-smoker volunteers increases attention

TRUE

(Pg 435, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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8. SSRIs may cause impotence

TRUE

(Pg 1088-9, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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4. Glutamate is a NMDA antagonist

FALSE

NMDA Agonist

(Pg 168, Exam Notes in Psych, Basic Sc, Malhi & Mitchell)

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10. Enalapril can increase plasma lithium levels

TRUE

(Pg 1052, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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11. D5 receptors belong to the D1 family of receptors

TRUE

(Pg 164, Exam Notes in Psych, Basic Sc, Malhi & Mitchell)

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7. Giving nicotine to non-smoker volunteers increases attention

True

The reinforcing actions of nicotine are very similar to those of cocaine and amphetamine(but more subtle), since dopaminergic cells in the mesolimobic dopamine pathway receive direct nicotinic cholinergic input, which is stimulated by cigarette smoking. This mediates the reward experienced by smokers including elevation of mood, enhancement of cognittion, and decrease of appetite.

ref Stahl Essentail Psychopharmacology, p518

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12. Alpha waves are slowed in EEG by chronic Benzodiazepine use.............TRUE

Can't find any reference but managed to discuss it with a few colleagues

However..... not 100%. so if you find a reference saying otherwise... please let me know

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12. Alpha waves are slowed in EEG by chronic Benzodiazepine use

'Slowed' is difficult to understand in this context...

Alpha waves will be alpha waves if they have a frequency of 8 to 13 hertz. If 'slowed' below 8 they will be another type of wave.

What I noticed in studies was the words 'attenuation' (less activity) or 'enhancement' (more activity) of that particular wave, measured in terms of density.

This study

Sleep EEG Power Spectra, Insomnia, and Chronic Use of Benzodiazepines

Célyne H. Bastien, PhD1;Mélanie LeBlanc, MPs1;Julie Carrier, PhD2; Charles M. Morin, PhD

Addresses the issue in terms of density saying in the results:

'Results showed no significant differences between drug-free insomnia sufferers and good sleepers.

However, benzodiazepine users exhibited significantly less delta and theta activity over the night than did good sleepers. When compared to drug-free insomnia sufferers, benzodiazepine users had less delta and theta activity within cycle 2 only.

Regarding high-frequency bands, benzodiazepine users had more beta 1 activity within cycle 3 than did good sleepers and more than both drug-free insomnia sufferers and good sleepers within cycle 4'

I would probably go for false...

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Dear safer

'slowed' here means : reduced in number..

so the answer remains as true

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easiest way to remember is

barbiturates and benzodiazepines slow the eeg activity so beta and alpha are slowed/decreased/less( waves more than 8htz are slowed) -----there is more/ increased delta and theta waves( waves with 0-8htz).

TCAS and NEuroleptics fasten the brain activity so there is more/increased/fast beta and alpha waves and less/decreased delta and theta waves

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2. Clozapine should not be prescribed with Carbamazepine

common sense answer is true but clever answer says 'see should not 'word then its false as BNF says clozapine to be avoided with carbamazepine due to increased risk of agranulocytosis.

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Ques: Clozapine should not be prescribed with Carbamazepine.

Ans: TRUE

Sodium Valproate is the safe combination.The potentional for carbamazapine to cause neutropenia may be increased by Clozapine.

Hasit

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Ques: Clozapine should not be prescribed with Carbamazepine.

Ans: TRUE

Sodium Valproate is the safe combination.The potentional for carbamazapine to cause neutropenia may be increased by Clozapine.

Hasit

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Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

4 WEEKS LEFT UNTIL THE WRITTEN PAPERS! CLICK HERE FOR THE COUNTDOWN CLOCK!

1. DHEA has an effect opposite to the effects of cortisol

2. Clozapine should not be prescribed with carbemazepine

3. From the known binding properties of clozapine, it would be expected to cause little postural hypotension

4. Glutamate is a NMDA antagonist

5. Acamprosate is a NMDA antagonist

6. With NA-reuptake inhibitors, presynaptic alpha2 receptors are likely to be more sensitive to blockade

7. Giving nicotine to non-smoker volunteers increases attention

8. SSRIs may cause impotence

9. Bupronorphine is a GABA antagonist

10. Enalapril can increase plasma lithium levels

11. D5 receptors belong to the D1 family of receptors

12. Alpha waves are slowed in EEG by chronic benzodiazepine use

13. An out patient freak develops acute dystonic reaction after consuming grape juice ? It's an EMI with a list of antipsychotics, SSSRI's, benzos,St Johns, etc

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2. Clozapine should not be prescribed with Carbamazepine  

common sense answer is true but clever answer says 'see should not 'word  then its false as BNF says  clozapine to be avoided with carbamazepine due to increased risk of agranulocytosis.

I can understand your reasoning but the manchester course -Schizophrenia August 2004 says carbamazapine should not be prescribed with clozapine

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