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Classification: Flashcards

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1
Q

What can most psych disorders be split into?

A
  • Organic (2ndry to physical causes)

- Functional

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2
Q

List 3 causes of organic disorders:

A
  • Cerebral tumours
  • Endocrine disorders
  • Psychoactive substance use disorders
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3
Q

List 2 function disorders:

A
  • Psychoses

- Neuroses

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4
Q

What are 2 other classifications of psych disorders?

A
  • Developmental
  • Behavioural

(e.g. personality disorders, learning disability, eating disorders, psychosexual disorders)

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5
Q

What is ICD-10?

A

For each psych disorder, a description of main clinical features, associated features and diagnostic guidelines are provided.

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6
Q

List 3 types of physical management of psych disorders:

A
  • Pharmacotherapy
  • ECT
  • Phototherapy
  • Psychosurgery
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7
Q

List 2 types of psychological management of psych disorders:

A
  • CBT

- Family therapy

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8
Q

List 2 types of psychosocial management:

A
  • OT

- Rehabilitation

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9
Q

What can hypnotics be used for?

A
  • Treating insomnia
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10
Q

What medications come under hypnotics/for treatment of insomnia?

A
  • Benzodiazapines

- Z- drugs (work in the same way as BZDs)

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11
Q

In what patient group should BZDs and Z-drugs be avoided in?

A

The elderly due to risk of ataxia and confusion falls.

Alternative is melatonin

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12
Q

What are the issues with hypnotics?

A
  • Tolerance develops within 3-14/7 on continuous use
  • Withdrawal can rebound insomnia

(short courses should be used in acutely distressed patients (2-4/52) )

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13
Q

List 3 antianxiety medication classes:

A
  • BZDs
  • Buspirone
  • B blockers
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14
Q

Why are beta blockers used in anxiety?

A

Reduce the autonomic symptoms (tremors, palpatations)

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15
Q

What should be prescribed in chronic anxiety?

A

(>4/52) - may us an antidepressant combined with a BZD until the antidepressant takes effect.

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16
Q

List 2 bendodiazepines:

A
  • Diazepam (long -acting)
  • Temazapam (short-acting)
  • Lorazepam
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17
Q

List 2 beta blockers:

A
  • Bisoprolol
  • propanolol
  • Atenolol
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18
Q

When should be used in panic disorders which are resistant to antidepressives?

A

Lorazepam or clonazepam (BZD)

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19
Q

What regime should BZD be used in?

A
  • Short periods (max. 2-4/52)
  • Lowest dose
  • For severe anxiety
20
Q

In what type of BZD is withdrawal more common?

A

Short acting (such as temazepam)

21
Q

How long does it take for one to develop tolerance to BZD?

A

3-14 days

22
Q

What should be done to avoid withdrawal symptoms?

A

Reduce BZD regime very slowly

23
Q

What should you advise patients on BZD to not do?

A

Driving - psychomotor impairment is a SE of BZDs.

24
Q

What can be used in BZD overdose and why?

A

Flumazenil (BZD antagonist)

25
Q

What are the side effects of 1) mild/mod BZD overdose and 2) extreme BZD overdose?

A

1) Intensification of therapy or, paradoxical excitation

2) Hospital admission required due to: coma, areflexia, cardiorespiratory depression, apnoea

26
Q

List 3 other mediactions that can be used as anxiolytics apart from BZD and Beta-blockers?

A
  • Melatonin (insomnia in >55s)
  • Z-drugs (non-BZD - Zopiclone)
  • Buspirone (short-term use in anxiety. does not alleviate BZD withdrawal)
27
Q

List the 5 classes of anti-depressants:

A
  • SSRIs (selective serotonin re-uptake Inhibitor)
  • TCAs (Tricyclic anti-depressants)
  • SNRIs (serotonin and noradrenaline re-uptake inhibitor)
  • NaSSA (Noradrenaline and specific serotonergic AD)
  • MAOIs (monoamine oxidase inhibitor)
28
Q

How long do antidepressant usually take to work? What is the risk during this time?

A

Usually take 10 days to start working and 4-6 weeks until fully effective.

Potential increase anxiety and suicidal ideation in first few weeks of Tx.

29
Q

What is the first line treatment of antidepressants? Give an example of 3 drugs in its class:

A

SSRIs - fluoxetine, sertraline, citalopram

30
Q

What are the symptoms of SSRI withdrawal syndrome?

A

Dizziness
Nausea
Headache
Sweating

31
Q

Which class of antidepressant is most effective in the treatment of bulimia nervosa?

A

SSRI

32
Q

List the 7 SSRI side effects:

A 
(7 S's)
Sleep difficulties
Suicidal thoughts
Stress (anxiety)
Stomach upset
Size (weight)
Sexual dysfunction
Serotonin syndrome
33
Q

List 5 indications for anti-depressants:

A
  • Depression
  • OCD
  • GAD
  • Panic disorder
34
Q

What antidepressant is best used in nocturnal enuresis?

A

TCAs (e.g. amitriptyline)

35
Q

Give an 3 examples of TCAs:

A
  • Amitriptyline
  • Clomipramine
  • Imipramine
36
Q

What are the SE of TCAs?

A

(TCA):
T - Toxic to heart (arrhythmia, heart block)
C - CNS (dizziness, sleep problems, confusion)
A - Anticholinergic (dry mouth, urinary retention)

37
Q

Give 3 features of a TCA overdose. What is the treatment for TCA overdose?

A
  • Seizures
  • Hypotension
  • Sinus tachycardia

Rx:

  • ABCDE
  • Activated charcoal (if <1hour)
  • Sodium bicarbonate for cardiac issues
  • Diazepam for seizures
38
Q

What anti-depressant is typically used for major depression or GAD? and give one example of one:

A

SNRIs - Duloxetine

39
Q

What the the SE of SNRIs?

A

S - same as SSRI +
H - Hypertension
A - Agitation
T - Tachycardia

40
Q

When are MAOIs typically used? Give an example of one:

A

Refractory depression, depression with severe anxiety, phobic disorders (basically complicated pictures.

Phenelzine

41
Q

What must be avoided when using MAOIs?

A
  • Food with tyramine-containing foods (hypertensive crisis)

- Use with L-Dopa and TCAs

42
Q

List the 4 side effects of MAOIs:

A 
(HAHA):
H - Hypotension
A - Anticholinergic SE
H - Hypertensive crisis
A - Anxiety/agitation
43
Q

What is serotonin syndrome?

A

(MAN):

1) Mental status changes (agitation, pressured speech)
2) Autonomic instability (tachycardia, diarrhoea, shivering)
3) Neuromuscular abnormalities (clonus, hyperreflexia, tremor, seizure)

44
Q

What is the treatment for serotonin syndrome?

A

BZDs

45
Q

List 5 non-pharmacological treatments for depression:

A
  • CBT
  • Exercise therapy
  • Psychoeducation
  • Interpersonal therapy
  • ECT

Psych (7 decks)

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