child psych Flashcards
what is a common presentation of MDE in kids
irritability
to define MDD, kid must display sx for how long
> 2weeks
mean age of onset for childhood MDD
14.3 yrs
recurrence rate for childhood MDD by 2 yrs
40% by 2 yrs
what is double depression
dysthymia + major depression
how is double depression characterized?
- severe and long episodes
- higher comorbidity
- incr suicidality
- worse social impact
1st line med tx in MDD
SSRI
drug to use for kids with comorbidity of ADHD and MDD
wellbutrin
MOA of wellbutrin
incr NE and DA
SE especially seen with wellbutrin
seizure
SE especially seen with effexor
incr in diastolic bp
SE especially seen with cymbalta
GI bleeding
autonomic instability, delirium, psychosis, myoclonic jerks
serotonin syndrome
dizziness, HA, N/V, diarrhea, insomnia, tremor, electric shock sensation
discontinuation syndrome
leading cause of disability age >5
depression
the black box warning for peds is relevant within 1st____weeks/months
within first 4 weeks
questions to ask if kid contemplating suicide
(1) plan?
(2) access to following thru with plan?
(3) intent?
(4) famhx of suicide
(5) previous suicide attempt
what differentiates childhood bipolar disorder from adult
mixed state with RAPID cycling
inner feeling of restlessness; assc’d with?
akathisia; assc’d with side effects of antipsychotics
which anticonvulsants known to cause the most weight gain?
Olanzapine + clozapine
which drug SE: hyper prolactinemia
risperdal (risperidone)
which drug SE: agranulocytosis
clozapril
which antipsychotics are asscd with less weight gain
abilify, geodon
which antipsychotic has less EPS sx?
seroquel
antipyschotic utilization in tx of bipolar disorder
reduce amt of DA in mesolimbic area of brain
severe muscle rigidity, fever, altered mental status, autonomic instability
neuroleptic malignant syndrome
which mood stability AE: PCOS
depakote
which mood stability AE: aplastic anemia agranulocytosis
tegretol
which mood stability AE: steven johnson syndrome
lamictal
what sort of adverse rxn: course tremor, slurred speech, confusion, N/V, seizure, coma
lithium toxicity
what NSAIDS should be avoided with lithium
ASA, ibuprofen
which mood stability AE: incr liver enzymes, thrombocytopenia, pancreatitis, PCOS
depakote
chronic severe persistent irritability
disruptive mood dysregulation disorder
1st line tx of ADHD
methylphenidate
only non stimulant approved for ADHD
straterra
how to tx kids with extreme hyperactivity and impulsivity?
alpha 2 agonist (clonidine, tenex)
3 domains of autism
(1) impairment in social interactions
(2) communication impairment
(3) restricted pattern of interest and stereotypical behavior
drugs that helps with socialization, language development, attn span, obsessions, aggression in tx of autism
namenda
what sort of delays are common in schizo patients/
language
what type of schizos have the best prognosis?
paranoid type schizo
