amk 14/10/23 Flashcards
what drug can be used to tx the somatic sx of GAD
propanolol( non seletive BB)
13yr boy, disruptive in class, poor academic performance and low rate of turning in homework,. distractable adn forgetful. started on ritalin what do you need to montiro
height and weight measurement
low BMI, exercisses obsessivel. GP wants to test power of muscles what will she use
sit up squat and stand test
Management of ptsd
watchful waiting may be used for mild symptoms lasting less than 4 weeks
military personnel have access to treatment provided by the armed forces
trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR) therapy may be used in more severe cases
drug treatments for PTSD should not be used as a routine first-line treatment for adults.
If drug treatment is used then venlafaxine or a selective serotonin reuptake inhibitor (SSRI), such as sertraline should be tried. In severe cases, NICE recommends that risperidone may be used
section 17 leabe
emproary shor tbasis if patietn deemed fit ( special occasion ie christmas)
community treatmetn order
long term treatment in the community
overdose of amitriptyline
IV sodium bicarb
features of amitriptyline overodsse
arrhythmias
seiures vomit flsuhign dialted pupils
benzo overdose
sluured speech
ataxia
reduced GCS
flumazenil
diogxin overdose sx
visual haloes confusion
high potassium
palpiations and BB
yellow green colour disturbance
paracetamol overdose
jaundice
abdo pain
coma
metabolic acidosis
n and v
loin pain
haematuria and proteinuria
side effect of olanzapine
weight gain in frist 6 months therfore increased risk of T2DM
risperidone se
galactorrhea
clozapine se
myocarditis and arrhythmias
agranulocytosis - weekly blood tests needed to detect early signs
haloperiodl se - typical
extrapyramidal se - dyskinesia
chlorpormazine se
cholinergic side effects - dry mouth etc
SSRI side effects and thigns to know
2 weeks before effective
ECG before starting
SSE - low sodiu,, QT elongations esp citalopram , GI distrubance and dry mouth , sleep
shoudl be continued for 6 motnhs post remission
shouldbe tapered when stoppign to avoid withdrawl
mirtazapien
increase appetiite, weight gain adn imrpoves sleep
lithium when to check levels
check levels 1 weeks after starting every week after therapetuic dose acheived - then every 3 months
emotionally unstable personality disorder - 1st line for this
dialectical behaviour therapy
what time period must sx be seen before a dx of depression can be made
no minimum time period2 weeks
A 42-year-old man was admitted to the emergency department with tremors and anxiety. His wife explains he recently attempted to stop drinking alcohol after several years of habitually drinking 15 units a night. He has no complaints of hallucinations and has not had a seizure.
What is the most appropriate management for this patient?
Tapering dose of chlordiazepoxide
pt has liver failure with alcohol withdrawal what tapering dose of what drug to you give
Lorazepam may be preferable in patients with hepatic failure
what drug lowers the seizure threshold
clozapine
ADHD do you need to be reffereed before starting methylphenidate
yes
A 75-year-old woman telephones her GP for advice. Her late husband passed away from cancer, and she has now been widowed for 4 months. The patient has a supportive family and is not clinically depressed, though was initially very tearful following her husband’s death. She occasionally feels apathetic and low-spirited, though this has significantly improved with time. However, for the last 2 weeks, she has heard her late husband talking to her on several occasions. She also thought she could see him once when out shopping with her friend, though recognises this is not possible.
What is the most appropriate next step in management?
Reassure and safety-net
Pseudo hallucinations can form part of the normal grieving process. Sufferers describe hearing, visualising, or even smelling their deceased loved one. These phenomena are often associated with acute grief, though can occur at any stage of bereavement. The above patient can therefore be reassured.
what is clang association
Clang associations - ideas related only by rhyme or being similar sounding
unexplained sx
Unexplained symptoms
Somatisation = Symptoms
hypoChondria = Cancer
