Defense Mechs and Drugs Flashcards by Robby Skinner

Transferring feelings to a more acceptable object

Displacement

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Altering perception of upsetting reality to be more acceptable

Distortion

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Separating a thought from it’s emotional components

Isolation of affect

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Avoiding conflict by expressing hostility covertly

Passive aggresion

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Intellectualization vs Rationalization

Intellectualization: using intellect to avoid uncomfortable feelings (learning a lot about a disease you have)
Rationalization: justifying behavior to avoid difficult truths

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Responding in a manner opposite to one’s actual feelings

Reaction formation

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Transferring emotional conflicts into physical symptoms

Somatization

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Channeling impulses into socially acceptable behaviors

Sublimation

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Suppression vs Repression

Suppression: putting unwanted feelings away to cope with reality
Repression: blocking unwanted feelings from entering consciousness

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Avoid what meds in bipolar disorder

TCAs and SSRIs (can trigger mania)

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Drug that can precipitate Lithium tox? use what instead?

NSAIDs

Use aspirin or sulindac instead

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Lithium MOA and therapeutic levels

Supreses inosital triphosphate

Level: 0.6-1.2

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Preferred treatment for bipolar in 1st trimester of pregnancy

Clonazepam

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Valproate AE

Elevated LFT, hepatitis, skin rash

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SJS from what bipolar med

Lamotrigine

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Most common AE of Carbamezapine

Rash

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Valproate therapeutic levels? Carbamezapine?

V: 6-12
C: 60-120

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Atypical lab in MDD

Dexa suppression test –> failure to suppress

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Think what with leaden paralysis in morning? best tx?

Atypical depression

Best tx is MAOis

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SSRI w/ most DDI

Paroxetine

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SSRI you don’t have to taper

Fluoxetine

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SSRO w/ fewest DDI

Citalopram

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SSRI discontinuation syndrome most common with what SSRIs

Sertraline and Fluvoxamine

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SSRI good for old skinny ladies? why?

Mirtazepine

Increases appetite and sleep

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Antidepressant to avoid in HTN patients

Venlafaxine

Drug for TCA overdose

IV NaHCO3 (helps metabolic acidosis and is cardioprotective)

Two low potency antipsychotics

Chlorpromazine and Thioridazine

Chlorpromazine AE

Purple grey metallic rash and jaundice

Prolonged QTC and pigmented retinopathy with what antipsychotic

Thioridazine

Akathisia tx

Propranolol (1st line) or benzo

Atypical AP with highest risk for EPS and inc prolactin

Risperidone

Weight neutral AAP but prolongs QTc

Ziprazodone

Weight neutral AAP that increases akathesia

Ariprazole

1 AE with olanzapine

Sedation (but don't forget about weight gain)

AAP that causes orthostatis and cataracts

Quetiapine (alpha blocking properties)

Panic attack drug regimen

SSRIs long term, benzos short term if no hx of addiction

Benzo withdrawal features

Seizures, fever, confusion, and hypertension

OCD tx

Clomipramine is gold standard | SSRIs are first line

Adjustment disorder vs Acute stress disorder

Acute stress must be life threatening

Anorexia labs

Hypotension, bradycardia, hypothermia

Long term complication of anorexia

Osteoporosis

Most common cause of death in anoerexia

Heart disease, then suicide

Labs of refeeding syndrome

Low PO4, lost Mg, Low Ca and fluid retention

What stage of sleep is night terrors

Slow wave (stage 3)

Look for what in a histrionic patient

Substance abuse or eating disorder

Ego syntonic vs Ego dystonic

syntonic doesn't think its their fault | dystonic realizes it is

2 biggest risk factors for delerium

Age, then underlying dementia

Alzheimer's gene

APP (on chr 21), Apo E 2

3 AchI drugs for alzhemiers

Donezepil, rivastigmine, galantamine

Tx for frontotemporal dementia

Olanzepine for severe disinhibition

Lewy body dementia path? Tx?

Intra-cytoplasmic Alpha-synuclein inclusions in neocortex | Give AchI

EEG of CJD

*Triphasic bursts*

What can B-blockers do in EtOH withdrawal

Mask signs of autonomic hyperactivity, but can follow hyperreflexia to dose benzes during withdrawal

Best benzos to give liver dz patients

Lorazepam, oxazepam, or temazepam (LOT)

WK caused by lack of

Thiamine (please don't miss that)

Why can pupils be dilated in heroin OD

Hypoxia 2/2 respiratory depression can cause

Cocaine or amphetamine withdrawal can cause

SI, Hypersomnia, depression, and anergia

Best 1st step for suspected cocaine/amphetamine intox

EKG the urine too screen

Tx for tachycardia in cocaine tox

CCB | *NO b-blockers*

Eriskson stages

65: integrity vs despair

Degrees of ID

Mild: 55-70 Mod: 40-55 Severe: 25-40 Profound:

Dx if ADD like symptoms but only in one setting

Normal, age appropriate behavior

Tourettes dx criteria

At lest once a day for 1 year without a tic free period longer than 3 months

First test for a 6 year old that stools in her clothes once every 2 weeks

Check for fecal retention