PHARMA DISEASES AND SUMMARY

Schizophrenia

Which psychiatric disorder is primarily managed using antipsychotic medications that modulate dopamine pathways?

D2

What specific dopamine receptor subtype is the primary target for antipsychotic therapeutic action?

Positive symptoms

Hallucinations, delusions, and paranoia belong to which category of schizophrenia symptoms improved by mesolimbic D2 blockade?

Negative symptoms

Apathy, anhedonia, and flat affect belong to which category of schizophrenia symptoms that can be worsened by D2 blockade in the mesocortical pathway?

Haloperidol

Which potent D2 receptor antagonist is indicated for schizophrenia, acute psychosis, and Tourette’s syndrome but carries a high risk for extrapyramidal symptoms?

Chlorpromazine

Which low-potency D2 antagonist was the first antipsychotic and presents with strong sedative, anticholinergic, and hypotensive side effects?

Dopamine Receptor Antagonists or DRAs

What is the pharmacological category for first-generation "typical" antipsychotics?

Serotonin-Dopamine Antagonists or SDAs

What is the pharmacological category for second-generation "atypical" antipsychotics?

Kiss and run

What descriptive term is used for the mechanism where atypical antipsychotics bind to D2 receptors briefly, leading to better tolerability?

Clozapine

Which medication is the gold standard for treatment-resistant schizophrenia but is not first-line due to side effects like agranulocytosis?

Neutropenia or Agranulocytosis

What most serious and potentially fatal side effect of Clozapine requires a CBC check every 3 months?

Immune system problems or uncontrolled epilepsy

What are two specific contraindications for the use of Clozapine?

Olanzapine

Which most common antipsychotic is used as a mood stabilizer but carries the greatest cardiometabolic risk and significant weight gain?

Metabolic syndrome

What long-term consequence can result from the significant weight gain associated with Olanzapine use?

Quetiapine

Which atypical antipsychotic has the lowest D2 affinity and is considered the best choice for patients with Parkinson’s disease?

Norquetiapine

What active metabolite of quetiapine has more potent antidepressant effects than the parent drug?

Lurasidone

Which antipsychotic is characterized by low weight gain and sedation because it lacks H1 and M1 antagonism?

Risperidone

Which atypical antipsychotic presents with a high risk of extrapyramidal symptoms and raised prolactin at higher doses?

Paliperidone

Which active metabolite of risperidone is not hepatically metabolized and can be given to patients with liver problems?

Aripiprazole

Which drug acts as a partial D2 agonist, providing a Goldilocks effect on dopamine?

Cariprazine

Which very new antipsychotic in the Philippines is defined by its high affinity for D3 receptors?

Amisulpride

Which second-generation antipsychotic is preferred for negative symptoms because it blocks presynaptic receptors at low doses?

Extrapyramidal symptoms or EPS

What movement-related pathology including tremors and slurred speech results from D2 blockade in the nigrostriatal pathway?

Hyperprolactinemia

What condition resulting from D2 blockade in the tuberoinfundibular pathway presents with galactorrhea and menstrual irregularities?

D2 receptor occupancy above 80 percent

What physiological threshold causes the emergence of side effects like EPS and prolactin elevation?

Neuroleptic Malignant Syndrome

What most severe and potentially fatal side effect of antipsychotics presents with diaphoresis, hyperthermia, and lead-pipe rigidity?

Dantrolene

What skeletal muscle relaxant is used as the antidote for Neuroleptic Malignant Syndrome?

SSRIs

Which class of antidepressants works by the selective and potent inhibition of the serotonin transporter or SERT?

Fluoxetine

Which SSRI is approved for bulimia and is described as an activating, energy-boosting medication?

Paroxetine

Which SSRI is preferred for anxiety due to its calming effects but is notorious for anticholinergic rebound withdrawal?

Anticholinergic rebound

What type of withdrawal reaction presenting with akathisia and GI symptoms occurs with sudden cessation of Paroxetine?

Escitalopram

Which drug is defined as a pure SERT inhibitor and is considered one of the safest first-line antidepressant choices?

Vortioxetine

Which antidepressant is the drug of choice for treating cognitive syndromes and lack of focus?

SNRIs

Which class of antidepressants, including Duloxetine, is preferred for patients presenting with somatic complaints or fibromyalgia?

Hypertension or Tachycardia

What are two cardiovascular contraindications for the use of SNRIs due to increased norepinephrine?

Duloxetine

Which prototype SNRI is used to relieve pain even in the absence of depression?

Tricyclic Antidepressants

Which class of antidepressants acts as sodium channel blockers and carries a high risk of cardiotoxicity in overdose?

Monoamine Oxidase Inhibitors or MAOIs

Which class of antidepressants is notorious for causing Serotonin Syndrome when combined with tyramine-rich foods?

Serotonin Syndrome

What condition presents with hyperreflexia, mydriasis, and hyperactive bowel sounds?

Cyproheptadine

What is the drug of choice for treating Serotonin Syndrome?

Bipolar I

Which type of disorder is defined by a florid manic episode alternating with a major depressive episode?

Lithium

Which mood stabilizer has a narrow therapeutic range of 0.8 to 1.2 mg/dL and is effective in reducing suicide risk?

Dehydration

What physical state causes an increase in lithium levels in the blood, leading to potential toxicity?

Arrhythmias, tremors, and nephrotoxicity

What are three symptoms of Lithium toxicity?

Valproic Acid

Which mood stabilizer is absolutely contraindicated in the first trimester of pregnancy due to neural tube defects?

Lamotrigine

Which anticonvulsant is most effective for bipolar depression but carries a risk of Stevens-Johnson Syndrome?

SJS or Stevens-Johnson Syndrome

What potentially fatal dermatologic condition is a side effect of Lamotrigine requiring slow titration?

GABAA

Which receptor is the primary target for sedatives, hypnotics, and anxiolytics?

Benzodiazepines

What class of drugs acts as positive allosteric modulators of GABAA receptors to provide immediate relief for anxiety?

Frequency of channel opening

What specific ion channel change is caused by benzodiazepines to enhance inhibition?

Duration of channel opening

What specific ion channel change is caused by barbiturates, making them generally more dangerous than benzodiazepines?

Midazolam

Which shortest-acting benzodiazepine is commonly used for quick sedation in procedures like colonoscopies?

Clorazepate Dipotassium

What is the longest-acting benzodiazepine?

Nitrazepam or Flunitrazepam

Which benzodiazepines are infamous for misuse as date-rape drugs?

Alprazolam

Which benzodiazepine is used for acute panic attacks and is preferred during the day because it is less sedating?

Clonazepam

Which benzodiazepine is preferred for use at night because it is more sedating?

Z-drugs

Which drug category purely targets Alpha 1 receptors on the GABAA complex to induce sleep?

Respiratory depression

What is the primary life-threatening side effect of benzodiazepine intoxication or overdose?

Flumazenil

What competitive antagonist is the drug of choice for reversing a benzodiazepine overdose?

Propranolol

Which lipophilic beta-blocker is the drug of choice for the autonomic symptoms of performance anxiety?

Reconsolidation

Which phase of fear memory is disrupted by Propranolol by blocking norepinephrine signaling?

Gabapentin and Pregabalin

Which alpha-2-delta ligands modulate glutamate release by binding to voltage-sensitive calcium channels?

HPA Axis

Which axis is central to the stress response and releases cortisol to prepare the body for action?

Hippocampus

Which brain structure associated with learning and memory shrinks under chronic stress due to elevated cortisol?

Amygdala

Which brain structure experiences increased activity and neural connections during chronic stress, intensifying anxiety?

Exercise and meditation

What are the two most powerful interventions to increase hippocampal size and counteract the effects of cortisol?

Atypical onset

What type of onset is suspected when a 75-year-old patient suddenly develops schizophrenic-like symptoms for the first time?

Vascular Dementia

Which pathology presents with an incrementally worsening course of cognitive decline due to vessel thrombosis or hemorrhage?

Dysthymic disorder

Which condition presents with a depressed mood lasting for at least two years?

Anorexia Nervosa

Which eating disorder is characterized by persistent intake restriction and an intense fear of gaining weight?

Bulimia Nervosa

Which eating disorder presents with recurrent binge eating followed by compensatory behaviors like vomiting?

Somatic Symptom Disorder

Which pathology presents with distressing physical symptoms resulting in disruption of daily life for more than 6 months?

Illness Anxiety Disorder

Which disorder involves a preoccupation with having or acquiring a serious illness despite minimal symptoms?

Conversion Disorder

Which pathology presents with neurological symptoms incompatible with medical findings, often linked to past trauma?

Adjustment Disorder

What is a time-limited maladaptive response to an identifier stressor occurring within 3 months of onset?

Sundowning

What condition presents with confusion and agitation in dementia patients during the late afternoon?

Kleine-Levin Syndrome

What disorder is specifically associated with the pathology of hypersomnia?

S2 license

What type of specialized license is required for a physician to prescribe restricted anxiolytics in the Philippines?

Alpha 1 subunit

Which GABAA receptor subunit is associated with the sedative effects of Z-drugs?

Alpha 2 and Alpha 3 subunits

Which GABAA subunits are associated with the anxiolytic effects of benzodiazepines?

Gamma 2 subunit

Which GABAA subunit is associated with the development of physiological dependence?

Alpha 5 subunit

Which GABAA subunit is associated with the learning and memory impairments caused by benzodiazepines?

Zero-order

What type of kinetics does alcohol follow during intoxication, where elimination occurs at a constant rate?

Bromism

What condition presenting with somnolence, delirium, and psychosis resulted from the historic use of bromide salts?

Phenobarbital

Which barbiturate is still used today as an anticonvulsant in neurocritical care?

Hypertensive crisis

What happens when a patient on MAOIs consumes food high in tyramine?

Diabetes insipidus

What renal condition can result from long-term Lithium toxicity?

Hyperprolactinemia

What condition presenting with galactorrhea and gynecomastia results from D2 blockade in the tuberoinfundibular tract?

Tyramine

Which chemical found in aged cheese and wine can cause a life-threatening reaction with MAOIs?

DOPA decarboxylase

Which enzyme is responsible for converting DOPA into dopamine?

Monoamine Oxidase

Which enzyme breaks down serotonin, norepinephrine, and dopamine in the synapse?

H1

Blockade of which receptor by antipsychotics leads to the side effect of sedation and weight gain?

Alpha 1

Antagonism of which noradrenergic receptor causes the side effect of orthostatic hypotension?

Muscarinic M1 and M3

Blockade of which receptors leads to anticholinergic effects like dry mouth and urinary retention?

5-HT1A

Which serotonin receptor acts as an autoreceptor to regulate firing rates?

5-HT2A

Which receptor is the primary target for antagonism by atypical antipsychotics to decrease EPS?

QT interval

Which cardiovascular parameter must be monitored because certain antipsychotics and SSRIs can cause its lengthening?

Seizure threshold

What physiological limit is lowered by antipsychotics like Clozapine, making seizures more likely?

cAMP/PKA/CREB

Which signaling pathway is disrupted by Propranolol to prevent the saving of fear memories?

D4

Which rare dopamine receptor is the specific target of Clozapine in the prefrontal cortex?