need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME 22 Answers

nbme22/Block 2/Question#36 (reveal difficulty score)
Which of the following drug effects is the ...
Anticholinergic ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: psych antidepressant

 Login (or register) to see more

 +52  upvote downvote
submitted by โˆ—seagull(1933)

Which of the following reasons is why this question is bull?

1) Using the word "cyclic" instead of tricyclic for clarity

2) Knowing all of epidemiology of all drugs

3) having to reason out that anticholinergic effects are probably the worst over alpha1 or H1 effects to no certainty.

4) The crippling depression of studying for days-to-weeks on end to probably do average on the test.

 Login (or register) to see more
nlkrueger  yo, re-fucking-tweet +26
aesalmon  I agree, I picked H1 because such a common complaint for those on TCAs is Sedation, I figure it might be so commonly seen as to be the "most common" reason for noncompliance. I suppose the "hot as a hare...etc" effects would be more severe/annoying, but I didn't think they were more common. +4
fcambridge  I just like to pretend that there's a reason this question is now in an NBME and no longer being used for the test. Hopefully they realized the idiocy of this question like we all do +1
link981  Since it said cyclic, I thought of using, discontinuing, then using again. These people who write these questions need take some English writing courses so they can write with CLARITY. Cyclic is not the same as Tricyclic. +6
waterloo  Incredibly awful question. one thought I did have when deciding between anticholinergic and antihistaminic - nortriptyline and desipramine are secondary amines that have less anti-cholinergic effects (from Sketchy Pharm) so maybe that's what they were getting at? That someone went out and made a new TCA drug that would have less anticholinergic effects. +
victor_abdullatif  This isn't testing drug epidemiology; it's actually asking "which of these side effects are caused by TCAs and would be the worst to experience?" +
tekkenman101  "worst to experience" is incredibly subjective lmao. +1

 +4  upvote downvote
submitted by โˆ—niboonsh(409)

tri-CyCliC antidepressent - anti C holinergic, C ant stand up (a1 block), C ardiotoxic (prolong qt by messing w na channels)

 Login (or register) to see more
waterloo  that's cool and all but there are so many side affects when it comes to TCAs. H1 antagonism, reduced libido, convulsions. +1

 +4  upvote downvote
submitted by โˆ—kard(52)

Tricyclic and tetracyclic antidepressants, also called cyclic antidepressants. The peripheral anticholinergic complaints of dry mouth, constipation, ocular side effects and urinary hesitancy are described and specific clinical guidelines for their effective management are provided.

So, most common reason for noncompliance with cyclic antidepressant therapy is its anticholinergic effect.

Note: Please if im mistaken, or my approach is mistaken, correct me... Thank you

 Login (or register) to see more

 +2  upvote downvote
submitted by โˆ—jessikasanz(9)

SSRI's make ya peepee not work, man no like when peepee not work. man stop taking SSRI. Point and Shoot: Erection= parasympathetic, so Ach is used for erections. Anticholingeric leads to lack of Ach which leads to no erection.

 Login (or register) to see more

 +1  upvote downvote
submitted by โˆ—lowyield(43)

my best guess for why anti-cholinergic is worse than adrenergic or histaminic was just b/c they stick atropine with diphenoxylate to prevent abuse (tbh tho idk if this logic stands at all but eh)

 Login (or register) to see more

 +1  upvote downvote
submitted by โˆ—umpalumpa(6)

Let's tackle down this question step-by-step: -C can be crossed-out (because TCA causes anti-M, not cholinomimetic side effects); -E can be crossed-out because TCA does not cause sympathomimetic ADR; -C can be crossed-out because anti-H effect is sedation (which is caused also by anticholinergic effect) + increased appetite/weight gain (which is something that, in my opinion, can still be under control by the pt-eg by correcting lifestyle); -the last 2 options are antiadrenergic and anticholinergic: both cause side effects that are difficult to keep under control; moreover, speaking in simple terms, anticholinergic cause a much higher number of ADR than antiadrenergic (alpha1 antagonism= ONLY orthostatic hypotension). Therefore, anticholinergic is the answer.

 Login (or register) to see more

 +1  upvote downvote
submitted by flexatronn(5)

idk about yall but sketchy pharm: that table with the rabbit and stuff is HY. Pay attention to those

 Login (or register) to see more

Must-See Comments from nbme22

sacredazn on Unrearranged immunoglobulin gene
seagull on Decreased binding of RNA polymerase
seagull on Anticholinergic
liverdietrying on Release of stored thyroid hormone from a ...
keycompany on Negative nitrogen balance
kernicterusthefrog on Displacement
mcl on Area labeled โ€˜Dโ€™
joha961 on Displacement
imgdoc on Area labeled โ€˜Cโ€™ (Abducens nucleus, right)
alwaysanonymous on 25 mL/cm H2O
drdoom on 1 in 600
seagull on Glutamine
bubbles on Acute retroviral infection
yotsubato on Phase variation

search for anything NEW!