1 - Psych Flashcards
Indications for use of antidepressants?
Depression Anxiety OCD/PTSD Bulimia Neuropathic pain
List the different classes of antidepressants?
SSRIs SNRIs TCAs MAOIs Atypical
List some SSRIs and some SNRIs
SSRI
- Citalopram/escitalopram
- Fluoxetine/paroxetine
- Sertraline
SNRIs
- Venlafaxine/desvenlafaxine
- Duloxetine
Name some TCAs
Amitriptyline
Imipramine
Lofepramine
Dosulepin
What are the common side effects associated with TCAS?
Anticholinergic
- Blurred vision
- Dry mouth
- Constipation
- Urinary retention
Weight gain
Sedation
Cardio
- Post hypertension
- Tachycardia
- Arrhythmias
What antidepressant is licensed for children?
Fluoxetine (SSRI)
20mg max dose
What are some common conditions that anxiety may be secondary to?
Substance misuse
Medical - Hyperthyroid/pheochromocytoma
Name some MOAIs
and their side effects
Irreversible = Phenelzine
Reversible = Moclobemide
Side effects:
- Insomnia
- Post hypertension
- Peripheral oedema
N.B. Decreases metabolism of barbiturates (sedatives ending “ital” e.g. Phenolbarbital
Criteria for detention under MHA? (5)
- Mental illness
- Impaired decision making
- Treatment required
- Significant risk to self/others
- Informal care refused/inappropriate
What are the Millan principles?
10 principles that must be considered when treating someone under the MHA.
- Non-discrimination
- Equality
- Respect for diversity
- Reciprocity
- Informal care
- Does patient need to be held under MHA? - Participation
- Respect for carers
- Least restrictive alternative
- least invasive treatment options possible - Benefit
- Child welfare
- MHA applies to all ages
What makes up the ADHD triad?
Hyperactivity
Impulsivity
Inattention
What are some predisposing/precipitating risk factors of ADHD?
Genetics
Smoking/drinking in pregnancy
Premature/eclampsia
Psychosocial adversity
Treatment of mild/mod ADHD?
Behavioural - Parental training Social skills training Sleep and diet Behavioural classroom Specific educational interventions
Treatment of mod-severe ADHD?
Behavioural Training
1st line = stimulants
2nd line = SNRI
3rd line = Alpha agonist
4th line = Antidepressants/antipsychotics
What BMI is associated with Anorexia Nervosa?
<17.5
Treatment of anorexia and bulimia nervosa?
CBT
Family based training (Maudsley approach)
Regular BP, height, weight, bloods and ECG to look for long QT
What is an affect illusion in anxiety?
Misinterpretation of a stimuli dependant on patients worries.
I.E sees shadow thinks she’s being chased
1st line treatment of GAD?
CBT & SSRI
Which antipsychotic reduces seizure threshold?
Clozapine
Example of stimulants used in ADHD
Amphetamine/dextroamphetamine (Adderall)
Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)
Dexmethylphenidate (Focalin)
Methylphenidate (Ritalin)
What differentiates mania and hypomania
To be manic you must display inflated self belief/esteem and flight of ideas
Must have symptoms for 7 days for mania vs 4 days for hypomania
Difference between BPAD I and BPAD II?
BPAD 1 = mania + depression
BPAD 2 = hypomania + depression
Can you prescribe an SSRI to someone on NSAID?
Yes but need PPI
Alternative to cabergoline?
bromocriptione
When is a platelet transfusion indicated?
<30
