Quiz
Psychopharmacology Exam #2: Eating disorders
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Questions in this quiz (53)
1Which diagnoses are most often associated with EDOs
- ASchizophrenia
- BAnxiety disorders
- CObsessive compulsive disorders
- DSubstance use disorders
2Anorexia nervosa has a predominantly female disorder with a mean age of onset of 15 years old
- ATrue
- BFalse
3Patients with Anorexia Nervosa (AN) and a psychiatric comorbidity have [blank_start]higher[blank_end] mortality rates than those without
- Ahigher
- Blower
4Comorbid disorders for Anorexia Nervosa include
- AMDD
- BAnxiety disorders (social phobia & GAD)
- COCD
- DSubstance use disorders
- EPersonality disorders
- FSchizophrenia
5With 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.
- ATrue
- BFalse
6Anorexia nervosa has the highest death rate of any mental health illness
- ATrue
- BFalse
7[blank_start]Food[blank_end] is your best medicine in aneroxia nervosa
- AFood
8What is the primary aim in the beginning stages of treatment of aneroxia nervosa?
- ANormalize and regulate eating patterns
- BTreat with medications to help with mood, andanxiety
- CBegin family-based interventions
- DIndividualized therapy interventions
9Prior to medication initiation for anorexia nervosa, a prescriber needs to have
- Aweight and height
- B% IBW
- COrthostatic vitals
- DEKG
- E24 hour diet diary
10SSRIs are the gold standard treament for sever depression, anxiety/OCD [blank_start]after[blank_end] weight restoration
- Aafter
- Bduring initial treatment before
11Which SSRI should be avoided with anorexia nervosa due to QTc prolongation?
- AFluoxetine
- BCitalopram
- CFluvoxamine
- DParoxetine
12SSRIs are FDA indicated for anorexia nervosa
- ATrue
- BFalse
13[blank_start]Fluoxetine[blank_end] and [blank_start]citalopram[blank_end] have some evidence for relapse prevention in weight-stored anorexics receiving treatment
- AFluoxetine
- BSetraline
- CParoxetine
- DFluvoxamine
- ESetraline
- Fcitalopram
- GFluvoxamine
- HParoxetine
14MOA for SSRI
- ALow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
- BSelectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
- C: Interacts with GABA receptors to enhance GABA effects
15Which atypical antipsychotic has some evidence to help restore weight more quickly as adjunctive treatment to other interventions?
- ARisperidone
- BApiprazole
- COlanzapine
16MOA for atypical antipsychotic used in anorexia nervosa is
- ASelectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CN
- BLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
- CBlocks voltage-dependent sodium & calcium channels
17Cigarettes [blank_start]decrease[blank_end] serum concentration of olanzapine
- Adecrease
- Bincrease
18Olanzapine will interact with anything causing CNS depression including opioids, barbiturates, benzodiazepines, general anesthetics, and anticonvulsants such as pregabalin
- ATrue
- BFalse
19There is mixed evidence for the use of BZ to reduce meal anxiety. Typically only ___________ used off-label
- AAlprazolam
- BClonazepam
- CLorazepam
- DDiazepam
20BZ should be avoided with opioids
- ATrue
- BFalse
21MOA for benzodiazepines is
- ASelectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
- BInteraction with GABA receptors to enhance GABA effects
- CLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
22The 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.
- ATrue
- BFalse
23Comormid illnesses for bulimia nervosa are similar to AN with
- AMood disorders
- BAnxiety Disorders
- COCD
- DSubstance abuse
- ESchizophrenia
- FPersonality disorders (Cluster B - dramatic, erratic)
24Medication of choice for bulimia nervosa is
- AAnticonvulsants
- BSSRIs
- CAtypical antipsychotics
- DTCA's
25Combined pharmacotherapy and psychotherapy appears to be more efficacious than either alone for bingeing and purging. This should be continued for a minimum of
- A6 months
- B12 months
- C18 months
- D2 years
26Which is considered 1st line for bulimia nervosa due to its efficacy and FDA approval for adults
- AFluoxetine
- BSertraline
- CCitalopram
- DParoxetine
27TCAs and anticonvulsants have been shown in studies to help reduce beingeing and purging, but SSRI Fluxetine is considered first line SSRI therapy
- ATrue
- BFalse
28Mechanism of action for Fluoxetine used in bulimia nervosa is
- Ainhibition of 5HT receptor, which leads to an increase in serotonin level
- Binhibiting 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
- CCombination of antagonism at D2 receptors in the mesolimbic pathway and 5HT2A receptors in the frontal cortex.
- Denhances the effects of GABA by increasing GABA affinity for the GABA recepto
29Fluoxetine is contraindicated in use with the following drugs
- ASelegeline
- BPimozide
- CLithium
- DLorazepam
30When prescribing SSRI Fluoxetine, need to consider other medications that have risk for serotonin syndrome
- ATriptans
- BOther antidepressants
- C5-HTP
- DSt. John's Wort
- EAnticonvulsants
31Which anticonvulsants are used off label to treat Bulimia Nervosa
- ATopiramate
- BZonisamide
- CValpromide
- DPrimidone
32What is the MOA for Topiramate which is used off label for bulimia nervosa
- AInhibits CNS neuronal uptake of serotonin
- BLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
- CBlocks voltage- dependent sodium & calcium channels
- DGABA activity and antagonizes glutamate receptors
33Binge eating disorder (BED) is the most common ED and almost as common in men as women. Age of onset is 18 years
- ATrue
- BFalse
34Select the other comorbid disorders of Binge Eating Disorder
- AOther ED's
- BSchizophrenic disorders
- CMood disorders (MDD, BPD)
- DAnxiety disorders
- EPTSD
- FElevated risk of suicide
35What medications are used for Binge Eating Disorders (BED)?
- ASSRI's
- BMood stabilizers
- CStimulants
- DAntipsychotics
36Topiramate, a mood stabilizer, has some evidence to suggest it is effective in which eating disorders
- AAnorexia nervosa
- BBinge Eating Disorder
- CBulimia Nervosa
- DAvoidant Restrictive Feeding Intake Disorder (ARFID)
37What are some of the concerns in using Topiramate (Topamax) for BN and BED
- AMay trigger restriction and development of AN
- BAdverse S/E including sedation and cognitive slowing
- CRisk of EPS
- DOrthostatic hypotension
38What is the MOA for Topiramate (Topamax)?
- AGABA activity and antagonizes glutamate receptors. Inhibits carbonic anhydrase
- BNon-selectively antagonizes central and peripheral histamine H1 receptors
- CLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
39Which drug interactions does a prescriber need to be concerned about with Topiramate (Topamax)?
- AAvoid with other sedating medications
- BAnything with CNS depression
- CMedications with potential to increase risk of metabolic acidosis
40What is the first FDA-approved medication to treat moderate to severe binge eating disorder?
- AAtomoxetine
- BLixdexamfetamine
- CMethylphenidate
- DDextroamphetamine
41What are some concerns with using Lisdexamfetamine for BED?
- ARisk of misuse or diversion
- BNumerous drug interactions that can increase CV events
- CCan cause EPS in high doses
- DCan cause constipation
42What is the MOA for Lisdexamfetamine?
- AStimulates CNS activity (sympathomimetic)
- BSelectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
- CLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
- DInteracts with GABA receptors to enhance GABA effects
43Avoidant Restrictive Feeding Intake Disorder (ARFID) is more predominant in males than females and has a younger age of onset, 11, than other EDs
- ATrue
- BFalse
44Which are true about ARFID?
- AMost common comorbidities are anxiety disorders, OCD, and neurodevelopmental disorders (autism, ADHD and intellectual disabilities)
- BMore common in households with high anxiety
- CSome medical conditions are associated including GERD, GI problems, vomiting
- DCommon with Personality Disorders Cluster B (dramatic, erratic)
45Common comorbid illnesses for ARFID include:
- AAnxiety disorders (GAD)
- BOCD
- CAutism spectrum disorder
- DLearning disorders
- EMood disorders
- FSchizophrenia
46Which appetite stimulants are used to treat ARFID?
- ACyproheptadine
- BCathine
- CChlorphentermine
- DDiethylpropion
47What is the MOA for Cyrpoheptadine?
- ANon-selectively antagonizes central and peripheral histamine H1 receptors
- BLow affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
- CInhibits CNS neuronal uptake of serotonin
48Which drugs does Cyproheptadine interact with?
- ASSRI
- BMAOIs
- CTCAs
- DAnticonvulsants
49The following are symptoms of disordered eating
- APicky eating – limited food choices, texture
- BUnhealthy dieting – calorie restriction
- CUnhealthy eating – skipping meals
- DUse of laxatives, diet pills, bingeing, vomiting
- ERelated to choking fears
- FRelated to food allergies
- GRelated to emetaphoibia
50What are symptoms of disordered eating as related to OCD?
- AContamination (foods, stores, brands of food, contact with certain people, organic or “green” foods, avoidance of fast foods)
- BColor of foods (need to eat all tan foods/avoid red foods – devil or blood)
- CSymmetry 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)
- DUse of laxatives, diet pills, bingeing, vomiting
51What are the guidelines for prescribing for disordered eating due to OCD?
- ATypically require higher doses as compared to patients with affective disorders or other anxiety disorders
- BMay take 10-12 weeks in OCD to determine efficacy
- CEmpirical data supports pharmacologic treatment of OCD
- DMultiple augmentation strategies for treatment-resistant OCD
- EHaving your mom tell you to "just eat already" while pinching your cheek
52The following types of drugs are used in the treatment of eating disorders due to OCD
- ASSRIs
- BTCA
- CAtypical antipsychotics
- DMood stabilizers
53These are pearls from Mary Carter about the treatment of EDOs
- APatients 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! - BPsychotropic medications do not work as well when nutrition status is poor.
- CMalnutrition may deplete trytophan which is necessary to make neurotransmitters like serotonin
- DPatients may begin to experience side effects when they are adequately weight restored possibly due to surge in neurotransmitters
- EGoal is to get to a dose that optimizes clinical efficacy while minimizing adverse effects
- APatients with ED’s are more susceptible to adverse side effects, especially if they are purging or if they are at a low weight.
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- Quiz on Psychopharmacology Exam #2: Eating disorders, created by Melanie Grynsztejn on 24/03/2018.
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- Melanie Grynsztejn
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