AAW - Psych Flashcards
patient with history of depression has:
urinary retention, dry mouth, convulsions, something wrong with their heart, hallucinations and diminishing mental status
what did they take too much of
antidote?
probably took too much of a TCA:
tri-Cyclics: Convulsions, Coma, Cardiotoxicity
treat with sodium bicarb
trazadone mech and use
blocks 5-HT2 and alpha 1 receptor
used mainly for insomnia, high doses have antidepressant effects
patient has hyperthermia, confusion, myoclonus, flushing, hyperreflexia, dilated pupils
how do you treat
give cyproheptadine for their probable serotonin syndrome
(SS: dilated pupils, hyperreflexia, hyperactive bowels
NMS: hyporeflexia, normal pupils, normal bowel sounds)
SE unique to thoridazine
reTinal deposits
buspirone mech
stimulates 5-HT1A receptors, used in generalized anxiety
takes 1-2 weeks to take effect
no interaction with EtOH
duloxetine mech
SNRI
inhibits 5-HT and NE reuptake
doxepin mech
amy, the traumatic care attendant has a “DOCtor PIN”
TCA - blocks reuptake of NE and 5-HT
amoxapine mech
amy, the traumatic care attendant is wearing A MOCCASIN
A MOXccasin
TCA - blocks reuptake of NE and 5-HT
chlorpromazine SE
corneal deposits
risperidone specific side effect
its an atypical antipsychotic
it can increase prolactin (causing lactation and gynecomastia leading to decreased GnRH, LH, and FSH)
mirtazapine mech, SE
alpha2 antagonist (increases release of NE and 5-HT)
also
5-HT2 and 5-HT3 receptor antagonist
SE: sedation, increased appetite, weight gain, dry mouth
patient has neuroleptic malignant syndrome
what happens to their calcium
it goes down because of rhabdo
combination of hyperkalemia, hyperphosphatemia, hyperuricemia
due to a combination of low albumin, hyperphosphatemia, tissue deposition of calcium, and impaired PTH secretion
old person being treated for fatigue, loss of appetite, difficulty concentrating, decreased sleep
put on a drug
then then get urinary retention, blurred vision, constipation, aggravation of glaucoma
what drug
a TCA causing cholinergic SE
Tx for NMS \
name 2
bromocriptine
benztropine
what does TCA overdose do you your acid base status
combined metabolic and respiratory acidosis
metabolic acidosis because TCAs reduce cardiac contractility leading to decreased tissue perfusion and production of lactic acid
also depresses breathing, causing a respiratory acidosis
Tx is bicarb
homeless man
somnolence, inability to perform tandem walking, oriented only to self, hepatomegaly, nystagmus
he has a vit def
what is his acid base status
metabolic acidosis with high lactate
B1 def
B1 helps catalyze pyruvate to Ach CoA, and if impaired, the pyruvate forms lactate instead
what part of the brain is blocked by antipsychotics in order to decrease the positive symptoms associated with schizophrenia
what part is
mesolimbic pathway blockage helps decrease the positive symptoms
treatment for benzo toxicity
mech
flumazenil - competitive antagonist at the benzodiazepine receptor site of the GABA-A channel
define akathisia and what neuro drug classically causes it after about 4 days
`state of agitation, distress, and restlessness that is an occasional SE of antipsychotic and antidepressant drugs
extrapyramidal effect seen with the use of antipsychotics
patient treated by a psychiatrist suddenly has facial twitching and tounge protrusion
what drug are they on
one that inhibits dopamine - usually first gen antipsychotics like haloperidol, fluphenazine, trifluphenazine
these “tardive dyskinesia” symptoms are probably because of upregulation of dopamine receptors after years of dopamine blockage
mech of benzos
increase the frequency of GABA channels opening and closing
