Behavioral Health Pharmacotherapy Flashcards
7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Behavioral Health Pharmacotherapy flashcards as text
A patient with bipolar I disorder is started on lithium. Which laboratory parameter is most critical to monitor for toxicity?
Answer: Serum lithium level
Serum lithium levels must be monitored closely because the therapeutic window is narrow (0.6–1.2 mEq/L) and toxicity occurs at levels above 1.5 mEq/L.
Which antipsychotic is most associated with QTc prolongation and requires baseline and periodic ECG monitoring?
Answer: Ziprasidone
Ziprasidone is associated with the greatest QTc prolongation among atypical antipsychotics, necessitating ECG monitoring and avoidance with other QTc-prolonging drugs.
An MTM pharmacist is reviewing a patient taking sertraline who reports new-onset agitation, tremor, hyperthermia, and diarrhea after adding linezolid. What is the most likely diagnosis?
Answer: Serotonin syndrome
Serotonin syndrome presents with the triad of mental status changes, autonomic instability, and neuromuscular abnormalities, and can occur when SSRIs are combined with linezolid (an MAO inhibitor).
Which benzodiazepine is preferred in elderly patients due to its lack of active metabolites?
Answer: Lorazepam
Lorazepam undergoes direct glucuronidation without producing active metabolites, making it safer in elderly patients whose hepatic function may be reduced.
A patient with schizophrenia on clozapine develops an absolute neutrophil count (ANC) of 900 cells/mm³. What is the most appropriate action?
Answer: Discontinue clozapine immediately
Per REMS guidelines, clozapine must be discontinued immediately if ANC falls below 1000 cells/mm³ (severe neutropenia) to prevent agranulocytosis.
Which medication used in alcohol use disorder works by blocking opioid receptors to reduce alcohol cravings?
Answer: Naltrexone
Naltrexone is an opioid antagonist that reduces the rewarding effects of alcohol and decreases craving by blocking mu-opioid receptors.
A patient taking phenelzine for depression eats aged cheese and develops a severe hypertensive crisis. What interaction caused this?
Answer: Tyramine accumulation due to MAO inhibition
MAO inhibitors like phenelzine prevent breakdown of tyramine (found in aged foods), causing excessive norepinephrine release and potentially fatal hypertensive crisis.