Melanie Grynsztejn
Quiz by , created more than 1 year ago

Quiz on Psychopharmacology Exam #2: Eating disorders, created by Melanie Grynsztejn on 24/03/2018.

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Melanie Grynsztejn
Created by Melanie Grynsztejn over 6 years ago
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Psychopharmacology Exam #2: Eating disorders

Question 1 of 53

1

Which diagnoses are most often associated with EDOs

Select one or more of the following:

  • Schizophrenia

  • Anxiety disorders

  • Obsessive compulsive disorders

  • Substance use disorders

Explanation

Question 2 of 53

1

Anorexia nervosa has a predominantly female disorder with a mean age of onset of 15 years old

Select one of the following:

  • True
  • False

Explanation

Question 3 of 53

1

Select from the dropdown list to complete the text.

Patients with Anorexia Nervosa (AN) and a psychiatric comorbidity have ( higher, lower ) mortality rates than those without

Explanation

Question 4 of 53

1

Comorbid disorders for Anorexia Nervosa include

Select one or more of the following:

  • MDD

  • Anxiety disorders (social phobia & GAD)

  • OCD

  • Substance use disorders

  • Personality disorders

  • Schizophrenia

Explanation

Question 5 of 53

1

With EDO, a detailed history to clarify timeline is critical because treating the core issue is essential for recovery. ADHD treatment, anxiety and depression may also cause weight loss. MDD may cause loss of appetite.

Select one of the following:

  • True
  • False

Explanation

Question 6 of 53

1

Anorexia nervosa has the highest death rate of any mental health illness

Select one of the following:

  • True
  • False

Explanation

Question 7 of 53

1

Fill the blank space to complete the text.

is your best medicine in aneroxia nervosa

Explanation

Question 8 of 53

1

What is the primary aim in the beginning stages of treatment of aneroxia nervosa?

Select one of the following:

  • Normalize and regulate eating patterns

  • Treat with medications to help with mood, andanxiety

  • Begin family-based interventions

  • Individualized therapy interventions

Explanation

Question 9 of 53

1

Prior to medication initiation for anorexia nervosa, a prescriber needs to have

Select one or more of the following:

  • weight and height

  • % IBW

  • Orthostatic vitals

  • EKG

  • 24 hour diet diary

Explanation

Question 10 of 53

1

Select from the dropdown list to complete the text.

SSRIs are the gold standard treament for sever depression, anxiety/OCD ( after, during initial treatment before ) weight restoration

Explanation

Question 11 of 53

1

Which SSRI should be avoided with anorexia nervosa due to QTc prolongation?

Select one of the following:

  • Fluoxetine

  • Citalopram

  • Fluvoxamine

  • Paroxetine

Explanation

Question 12 of 53

1

SSRIs are FDA indicated for anorexia nervosa

Select one of the following:

  • True
  • False

Explanation

Question 13 of 53

1

Select from the dropdown lists to complete the text.

( Fluoxetine, Setraline, Paroxetine, Fluvoxamine ) and ( Setraline, citalopram, Fluvoxamine, Paroxetine ) have some evidence for relapse prevention in weight-stored anorexics receiving treatment

Explanation

Question 14 of 53

1

MOA for SSRI

Select one of the following:

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

  • Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS

  • : Interacts with GABA receptors to enhance GABA effects

Explanation

Question 15 of 53

1

Which atypical antipsychotic has some evidence to help restore weight more quickly as adjunctive treatment to other interventions?

Select one of the following:

  • Risperidone

  • Apiprazole

  • Olanzapine

Explanation

Question 16 of 53

1

MOA for atypical antipsychotic used in anorexia nervosa is

Select one of the following:

  • Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CN

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

  • Blocks voltage-dependent sodium & calcium channels

Explanation

Question 17 of 53

1

Select from the dropdown list to complete the text.

Cigarettes ( decrease, increase ) serum concentration of olanzapine

Explanation

Question 18 of 53

1

Olanzapine will interact with anything causing CNS depression including opioids, barbiturates, benzodiazepines, general anesthetics, and anticonvulsants such as pregabalin

Select one of the following:

  • True
  • False

Explanation

Question 19 of 53

1

There is mixed evidence for the use of BZ to reduce meal anxiety. Typically only ___________ used off-label

Select one of the following:

  • Alprazolam

  • Clonazepam

  • Lorazepam

  • Diazepam

Explanation

Question 20 of 53

1

BZ should be avoided with opioids

Select one of the following:

  • True
  • False

Explanation

Question 21 of 53

1

MOA for benzodiazepines is

Select one of the following:

  • Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS

  • Interaction with GABA receptors to enhance GABA effects

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

Explanation

Question 22 of 53

1

The epdimiology of Bulimia Nervosa is greater in females than males and onset is later than AN, either late adolescence or early adulthood at 19.4 years as compared to 15 years.

Select one of the following:

  • True
  • False

Explanation

Question 23 of 53

1

Comormid illnesses for bulimia nervosa are similar to AN with

Select one or more of the following:

  • Mood disorders

  • Anxiety Disorders

  • OCD

  • Substance abuse

  • Schizophrenia

  • Personality disorders (Cluster B - dramatic, erratic)

Explanation

Question 24 of 53

1

Medication of choice for bulimia nervosa is

Select one of the following:

  • Anticonvulsants

  • SSRIs

  • Atypical antipsychotics

  • TCA's

Explanation

Question 25 of 53

1

Combined pharmacotherapy and psychotherapy appears to be more efficacious than either alone for bingeing and purging. This should be continued for a minimum of

Select one of the following:

  • 6 months

  • 12 months

  • 18 months

  • 2 years

Explanation

Question 26 of 53

1

Which is considered 1st line for bulimia nervosa due to its efficacy and FDA approval for adults

Select one of the following:

  • Fluoxetine

  • Sertraline

  • Citalopram

  • Paroxetine

Explanation

Question 27 of 53

1

TCAs and anticonvulsants have been shown in studies to help reduce beingeing and purging, but SSRI Fluxetine is considered first line SSRI therapy

Select one of the following:

  • True
  • False

Explanation

Question 28 of 53

1

Mechanism of action for Fluoxetine used in bulimia nervosa is

Select one of the following:

  • inhibition of 5HT receptor, which leads to an increase in serotonin level

  • inhibiting the neuronal reuptake of the neurotransmitters norepinephrine and serotonin. It binds the sodium-dependent serotonin transporter and sodium-dependent norepinephrine transporter reducing the reuptake of norepinephrine and serotonin by neurons

  • Combination of antagonism at D2 receptors in the mesolimbic pathway and 5HT2A receptors in the frontal cortex.

  • enhances the effects of GABA by increasing GABA affinity for the GABA recepto

Explanation

Question 29 of 53

1

Fluoxetine is contraindicated in use with the following drugs

Select one or more of the following:

  • Selegeline

  • Pimozide

  • Lithium

  • Lorazepam

Explanation

Question 30 of 53

1

When prescribing SSRI Fluoxetine, need to consider other medications that have risk for serotonin syndrome

Select one or more of the following:

  • Triptans

  • Other antidepressants

  • 5-HTP

  • St. John's Wort

  • Anticonvulsants

Explanation

Question 31 of 53

1

Which anticonvulsants are used off label to treat Bulimia Nervosa

Select one or more of the following:

  • Topiramate

  • Zonisamide

  • Valpromide

  • Primidone

Explanation

Question 32 of 53

1

What is the MOA for Topiramate which is used off label for bulimia nervosa

Select one of the following:

  • Inhibits CNS neuronal uptake of serotonin

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

  • Blocks voltage- dependent sodium & calcium channels

  • GABA activity and antagonizes glutamate receptors

Explanation

Question 33 of 53

1

Binge eating disorder (BED) is the most common ED and almost as common in men as women. Age of onset is 18 years

Select one of the following:

  • True
  • False

Explanation

Question 34 of 53

1

Select the other comorbid disorders of Binge Eating Disorder

Select one or more of the following:

  • Other ED's

  • Schizophrenic disorders

  • Mood disorders (MDD, BPD)

  • Anxiety disorders

  • PTSD

  • Elevated risk of suicide

Explanation

Question 35 of 53

1

What medications are used for Binge Eating Disorders (BED)?

Select one or more of the following:

  • SSRI's

  • Mood stabilizers

  • Stimulants

  • Antipsychotics

Explanation

Question 36 of 53

1

Topiramate, a mood stabilizer, has some evidence to suggest it is effective in which eating disorders

Select one or more of the following:

  • Anorexia nervosa

  • Binge Eating Disorder

  • Bulimia Nervosa

  • Avoidant Restrictive Feeding Intake Disorder (ARFID)

Explanation

Question 37 of 53

1

What are some of the concerns in using Topiramate (Topamax) for BN and BED

Select one or more of the following:

  • May trigger restriction and development of AN

  • Adverse S/E including sedation and cognitive slowing

  • Risk of EPS

  • Orthostatic hypotension

Explanation

Question 38 of 53

1

What is the MOA for Topiramate (Topamax)?

Select one of the following:

  • GABA activity and antagonizes glutamate receptors. Inhibits carbonic anhydrase

  • Non-selectively antagonizes central and peripheral histamine H1 receptors

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

Explanation

Question 39 of 53

1

Which drug interactions does a prescriber need to be concerned about with Topiramate (Topamax)?

Select one of the following:

  • Avoid with other sedating medications

  • Anything with CNS depression

  • Medications with potential to increase risk of metabolic acidosis

Explanation

Question 40 of 53

1

What is the first FDA-approved medication to treat moderate to severe binge eating disorder?

Select one of the following:

  • Atomoxetine

  • Lixdexamfetamine

  • Methylphenidate

  • Dextroamphetamine

Explanation

Question 41 of 53

1

What are some concerns with using Lisdexamfetamine for BED?

Select one or more of the following:

  • Risk of misuse or diversion

  • Numerous drug interactions that can increase CV events

  • Can cause EPS in high doses

  • Can cause constipation

Explanation

Question 42 of 53

1

What is the MOA for Lisdexamfetamine?

Select one of the following:

  • Stimulates CNS activity (sympathomimetic)

  • Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

  • Interacts with GABA receptors to enhance GABA effects

Explanation

Question 43 of 53

1

Avoidant Restrictive Feeding Intake Disorder (ARFID) is more predominant in males than females and has a younger age of onset, 11, than other EDs

Select one of the following:

  • True
  • False

Explanation

Question 44 of 53

1

Which are true about ARFID?

Select one or more of the following:

  • Most common comorbidities are anxiety disorders, OCD, and neurodevelopmental disorders (autism, ADHD and intellectual disabilities)

  • More common in households with high anxiety

  • Some medical conditions are associated including GERD, GI problems, vomiting

  • Common with Personality Disorders Cluster B (dramatic, erratic)

Explanation

Question 45 of 53

1

Common comorbid illnesses for ARFID include:

Select one or more of the following:

  • Anxiety disorders (GAD)

  • OCD

  • Autism spectrum disorder

  • Learning disorders

  • Mood disorders

  • Schizophrenia

Explanation

Question 46 of 53

1

Which appetite stimulants are used to treat ARFID?

Select one of the following:

  • Cyproheptadine

  • Cathine

  • Chlorphentermine

  • Diethylpropion

Explanation

Question 47 of 53

1

What is the MOA for Cyrpoheptadine?

Select one of the following:

  • Non-selectively antagonizes central and peripheral histamine H1 receptors

  • Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)

  • Inhibits CNS neuronal uptake of serotonin

Explanation

Question 48 of 53

1

Which drugs does Cyproheptadine interact with?

Select one or more of the following:

  • SSRI

  • MAOIs

  • TCAs

  • Anticonvulsants

Explanation

Question 49 of 53

1

The following are symptoms of disordered eating

Select one or more of the following:

  • Picky eating – limited food choices, texture

  • Unhealthy dieting – calorie restriction

  • Unhealthy eating – skipping meals

  • Use of laxatives, diet pills, bingeing, vomiting

  • Related to choking fears

  • Related to food allergies

  • Related to emetaphoibia

Explanation

Question 50 of 53

1

What are symptoms of disordered eating as related to OCD?

Select one or more of the following:

  • Contamination (foods, stores, brands of food, contact with certain people, organic or “green” foods, avoidance of fast foods)

  • Color of foods (need to eat all tan foods/avoid red foods – devil or blood)

  • Symmetry related (need to eat same amount as sibling to maintain identical weight and shape or chewing same number of times on each side of mouth)

  • Use of laxatives, diet pills, bingeing, vomiting

Explanation

Question 51 of 53

1

What are the guidelines for prescribing for disordered eating due to OCD?

Select one or more of the following:

  • Typically require higher doses as compared to patients with affective disorders or other anxiety disorders

  • May take 10-12 weeks in OCD to determine efficacy

  • Empirical data supports pharmacologic treatment of OCD

  • Multiple augmentation strategies for treatment-resistant OCD

  • Having your mom tell you to "just eat already" while pinching your cheek

Explanation

Question 52 of 53

1

The following types of drugs are used in the treatment of eating disorders due to OCD

Select one or more of the following:

  • SSRIs

  • TCA

  • Atypical antipsychotics

  • Mood stabilizers

Explanation

Question 53 of 53

1

These are pearls from Mary Carter about the treatment of EDOs

Select one or more of the following:

  • Patients with ED’s are more susceptible to adverse side effects, especially if they are purging or if they are at a low weight.
    START LOW AND GO SLOW!

  • Psychotropic medications do not work as well when nutrition status is poor.

  • Malnutrition may deplete trytophan which is necessary to make neurotransmitters like serotonin

  • Patients may begin to experience side effects when they are adequately weight restored possibly due to surge in neurotransmitters

  • Goal is to get to a dose that optimizes clinical efficacy while minimizing adverse effects

Explanation

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