Psychopharmacology: Alprazolam and Quetiapine

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Questions and Answers

What is a common adverse side effect associated with Alprazolam?

Agitation

Hypertension

Ataxia (correct)

Headache

Which of the following dosage forms is available for Quetiapine Fumarate?

Oral suspension

Tablet (correct)

Sublingual tablet

Disintegrating tablet

What is the mechanism of action for Alprazolam?

Inhibits dopamine receptors

Enhances GABA effects (correct)

Stimulates adrenergic receptors

Blocks serotonin uptake

Which FDA indication is NOT applicable to Quetiapine Fumarate?

Panic disorder Signup and view all the answers

What patient counseling point is essential for those taking Quetiapine Fumarate?

Take with food Signup and view all the answers

Which common adverse side effect is shared between Alprazolam and Quetiapine Fumarate?

Somnolence Signup and view all the answers

What precaution should be taken for patients prescribed Alprazolam?

Avoid activities that require mental alertness Signup and view all the answers

Which characteristic is true regarding Metoprolol Tartrate?

It acts as an antihypertensive Signup and view all the answers

What is one common adverse side effect of Fluticasone Propionate?

Sedation Signup and view all the answers

What is the FDA indication for Donepezil?

Alzheimer disease Signup and view all the answers

Which class does Clopidogrel Bisulfate belong to?

Hematological agent Signup and view all the answers

What is the mechanism of action of Donepezil?

Central cholinesterase inhibitor Signup and view all the answers

What is a recommended counseling point for patients taking Clopidogrel Bisulfate?

Report signs and symptoms of bleeding Signup and view all the answers

Which of the following is a common adverse side effect associated with Clopidogrel Bisulfate?

Asthenia Signup and view all the answers

Which dosage form is NOT associated with Fluticasone Propionate?

Disintegrating tablet Signup and view all the answers

What adverse effect may occur with Fluticasone Propionate upon initial use?

Delayed adverse effects Signup and view all the answers

What is the FDA indication for 24h Sprinkle?

Angina Signup and view all the answers

What is the mechanism of action for Tamsulosin Hydrochloride?

Postsynaptic α<del>1</del>-adrenergic receptor blocker Signup and view all the answers

What patient counseling advice is specifically important for those taking Oxycodone Hydrochloride?

Avoid activities that require motor coordination Signup and view all the answers

What should be done to manage common side effects of Oxycodone Hydrochloride?

Use laxatives to prevent constipation Signup and view all the answers

Which of the following is a common adverse side effect of Tamsulosin Hydrochloride?

Dizziness Signup and view all the answers

What is a clinical pearl regarding the transition from injectable metoprolol to oral administration?

2.5 mg PO to 1 mg IV Signup and view all the answers

What important patient counseling point is relevant for those taking 24h Sprinkle?

Avoid alcohol Signup and view all the answers

What potential risk is associated with the abrupt discontinuation of Oxycodone Hydrochloride?

Withdrawal symptoms Signup and view all the answers

Which of the following is a common side effect of Cyclobenzaprine Hydrochloride?

Xerostomia Signup and view all the answers

What is the classification of Lisdexamfetamine Dimesylate?

CNS agent for ADHD Signup and view all the answers

What is the recommended method of taking Lisdexamfetamine Dimesylate?

With or without food in the morning Signup and view all the answers

What FDA indication does Oxybutynin Chloride have?

Overactive or neurogenic bladder Signup and view all the answers

Which adverse effect is associated with Mirtazapine?

Irritability Signup and view all the answers

What is the dosage form of Cyclobenzaprine Hydrochloride?

Capsule ER Signup and view all the answers

Which of the following interacts poorly with Cyclobenzaprine Hydrochloride?

Opioids Signup and view all the answers

What is the method of action for Oxybutynin Chloride?

Muscarinic receptor antagonist Signup and view all the answers

Which of the following is a common adverse side effect of Methylphenidate?

Headache Signup and view all the answers

What class of medication does Allopurinol belong to?

Gout agent Signup and view all the answers

What is the mechanism of action (MOA) of Allopurinol?

Xanthine oxidase inhibitor Signup and view all the answers

What counseling point is recommended for patients taking Risperidone?

Take with food Signup and view all the answers

Which of the following dosage forms is available for Methylphenidate?

Tablet ER Signup and view all the answers

What should patients using Allopurinol avoid to ensure effectiveness?

Alcohol and caffeine Signup and view all the answers

What is a significant potential risk associated with Methylphenidate use?

High potential for abuse Signup and view all the answers

What adverse effect is commonly associated with Risperidone?

Weight gain Signup and view all the answers

Study Notes

Alprazolam (Xanax)

Antianxiety Agent
Available in tablet, disintegrating tablet, ER tablet, and solution forms
FDA approved for anxiety and panic disorder
Enhances the postsynaptic effect of GABA
Causes drowsiness
Avoid activities requiring mental alertness
Avoid alcohol
Do not crush tablets
Can be mixed in liquid or semi-solid food
Discard half a tablet if only taking half
Not for use in children
Reduce dose in patients with hepatic impairment
Avoid use in the elderly
Has addictive potential
Avoid abrupt discontinuation after chronic use
May cause seizures
Common adverse side effects: Ataxia, lethargy, retrograde amnesia, somnolence, weight gain, change in appetite, constipation, fatigue, cognitive dysfunction, decreased libido

Quetiapine Fumarate (Seroquel)

Antipsychotic
Available in tablet and ER tablet forms
FDA approved for bipolar disorder and schizophrenia
Antagonizes 5-HT1a, 5-HT2, dopamine D1 and D2, histamine H1, and adrenergic α1 and α2 receptors
Take with food
Avoid alcohol
Avoid activities requiring mental alertness
Rise slowly from a sitting position
Report signs and symptoms of hyperglycemia, bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome
Avoid concomitant use with opioids
Elderly patients with dementia-related psychosis taking quetiapine have an increased risk of death compared to placebo
Common adverse side effects: Agitation, headache, HTN, somnolence, weight gain, xerostomia

Metoprolol Tartrate (Lopressor)

Antihypertensive
Available in tablet, ER tablet, ER capsule, and 24h Sprinkle forms
FDA approved for angina, HF with reduced ejection fraction, HTN, and AMI
Cardioselective β-adrenergic blocker
Take on an empty stomach
Avoid alcohol
Avoid abrupt discontinuation
Report signs and symptoms of hypotension, heart failure, or exacerbation of angina
In diabetics, this drug may mask symptoms of hypoglycemia.
Limit use of calcium channel blockers
Injectable metoprolol is also used in atrial fibrillation patients
Conversion from IV to PO: 2.5 mg po to 1 mg IV
Common adverse side effects: Dizziness, fatigue, hypotension

Tamsulosin Hydrochloride (Flomax)

BPH agent
Available in oral capsule form
FDA approved for benign prostatic hyperplasia
Selectively blocks postsynaptic α1-adrenergic receptors
Administer 30 minutes after the same meal daily
Avoid activities that require coordination
May cause vertigo and dizziness
Rise slowly from a sitting position
Syncope or loss of consciousness is possible after the first dose
Not first-line treatment
Has a longer half-life
May result in hypotension less often than other agents
Common adverse side effects: Dizziness, headache, abnormal ejaculation, rhinitis

Oxycodone Hydrochloride (OxyContin, Roxicodone)

Opioid Analgesic
Available in capsule, tablet IR, tablet ER 12h abuse-deterrent, solution, and concentrate forms
FDA approved for chronic, moderate, and severe pain
Mu agonist
Use laxative to prevent constipation
May cause drowsiness
Avoid tasks requiring motor coordination
Avoid alcohol or other CNS depressants
Tolerance and dependence may occur
Avoid abrupt discontinuation
Do not crush tablets
ER: Do not use in children
Do not use with benzodiazepines
Use in combination with acetaminophen for beneficial pain management
FDA is requiring updates to opioid labeling
Common adverse side effects: Constipation, GI distress, sedation, sweating, pruritus

Fluticasone Propionate (nasal) (Flonase)

Antiallergy agent
Available in nasal spray and nasal exhaler suspension forms
FDA approved for allergic rhinitis, non-allergic rhinitis, and nasal polyps
Corticosteroids: anti-inflammatory, antipruritic, vasoconstrictive
Show patients how to properly administer
Monitor for signs and symptoms of toxicity
May have a scent
Relief or adverse effects may occur for several days after the first use
Available OTC
Topical and inhalation forms are also available for the treatment of asthma and other allergic disorders
Common adverse side effects: Headache, nasal irritation, burning

Donepezil (Aricept)

Alzheimer's Dementia Agent
Available in tablet and disintegrating tablet forms
FDA approved for Alzheimer's disease and dementia
Central cholinesterase inhibitor
Take at bedtime with or without food
Adverse effects may be more frequent at dose escalation and will resolve when continued
Safety and effectiveness not established in children
No evidence shows that it alters the course of Alzheimer's
Common adverse side effects: Asthenia

Clopidogrel Bisulfate (Plavix)

Hematological Agent
Available in tablet form
FDA approved for acute ST segment elevation MI managed, and thrombosis prevention in ASCVD
Platelet aggregation inhibitor
Report signs and symptoms of bleeding
Do not stop therapy abruptly
Discontinue 5 days prior to elective surgery if antiplatelet effect is desired
Actively metabolized by CYP2C19
Common adverse side effects: Headache

Methylphenidate (Ritalin, Methylin, Metadate, Concentra)

CNS agent for ADHD
Available in tablet, chewable tablet, chewable tablet ER, tablet ER, disintegrating tablet ER, tablet ER 24 hours, capsule ER, capsule ER 24 h, solution, suspension, patch, and transdermal patch forms
FDA approved for ADHD and narcolepsy
CNS stimulant (C-II)
Avoid taking at night as it may cause insomnia
Avoid abrupt discontinuation
Patch: Apply at the same time each day and alternate hips. Remove after 9 hours
High potential for abuse
Consider drug holidays
Avoid confusion over multiple different brand names and formulations
Common adverse side effects: Weight loss, loss of appetite, headache, insomnia, irritability

Allopurinol (Zyloprim)

Gout agent
Available in tablet form
FDA approved for gout, hyperuricemia, and nephrolithiasis
Xanthine oxidase inhibitor: Decreases the production of uric acid
Take after meals
Maintain adequate hydration
Avoid alcohol and caffeine
Seek medical attention if experiencing myelosuppression, agranulocytosis, or Steven Johnson syndrome
Full effect in chronic gout may take 2-6 weeks, slow dose titration
Common adverse side effects: None known

Risperidone (Risperdal)

Antipsychotic
Available in tablet, dispersible tablet, and solution form
FDA approved for autistic disorder, acute manic or mixed episodes of bipolar I, and schizophrenia
Serotonin 5-HT2 antagonist with weaker dopamine antagonism
Take with food
Avoid alcohol and other CNS depressants
Avoid activities requiring mental alertness or coordination
Rise slowly from a sitting or supine position
Report signs and symptoms of hyperglycemia
Can be mixed in coffee, orange juice, and low-fat milk, but not cola or tea
Common adverse side effects: Edema, headache

Cyclobenzaprine Hydrochloride (Flexeril, Amrix, Fexmid)

Muscle Relaxant
Available in tablet and capsule ER forms
FDA approved for skeletal muscle spasm
Centrally acting skeletal muscle relaxant
Avoid activities requiring mental alertness
Should be used only for short periods (2-3 weeks)
Avoid use with opioids
Avoid use in the elderly
Common adverse side effects: Xerostomia, headache, dizziness, drowsiness

Lisdexamfetamine Dimesylate (Vyvanse)

CNS agent for ADHD
Available in capsule and chewable tablet forms
FDA approved for ADHD and binge eating disorder
Prodrug: Amphetamine CNS stimulant (C-II)
Take dose in the morning with or without food
Can be dissolved in water, yogurt, or orange juice
Report any chest pain, palpitations, or dyspnea
High potential for abuse
A complete family and patient history of serious CV adverse events is required before administration.
Common adverse side effects: Insomnia, irritability, loss of appetite, upper abdominal pain, xerostomia

Oxybutynin Chloride (Ditropan, Ditropan XL)

Urinary bladder modifier
Available in tablet, tablet ER, syrup, and transdermal gel forms
FDA approved for overactive or neurogenic bladder
Competitive muscarinic receptor antagonist
No important patient counseling
Be cautious in the decision to engage in potentially dangerous activities until drug effects have been determined.
Common adverse side effects: Constipation, xerostomia, blurred vision

Mirtazapine (Remeron)

Antidepressant
Available in tablet and disintegrating tablet forms
FDA approved for depression
α2 antagonist
Take in the evening prior to sleep.

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Description

Explore the key features, uses, and side effects of Alprazolam and Quetiapine Fumarate. This quiz covers essential information on these medications, including their classifications, approved uses, and important patient considerations. Test your knowledge on these antianxiety and antipsychotic agents.