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Psychiatry Shelf > Drugs > Flashcards

Drugs Flashcards

1
Q

HAM se’s

A

antiHistamine - sedation, w/g
antiAdrenergic - hypotension
antiMuscarinic - dry mouth, blurred vision, urinary retention

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2
Q

Serotonin syndrome

A

seen with SSRI’s and MAOIs combined (or triptan + SSRI)

confusion, flushing, tremor, myoclonic jerks, hypertonicity, rhabdomyolysis, renal failure death, shivering

  • should wait TWO WEEKS, before giving SSRI + MAOI
  • if suspect, discontinue med, try CCB (nifedipine) or chlopromazine/phentolamine
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3
Q

Hypertensive crisis

A

seen with buildup of catecholamines d/t MAOIs + tyramine

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4
Q

akathisia

A

restlessness/agitation - unable to sit still (days to months) - seen after using high dose typical antipsychotics

tx: benzos

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5
Q

dystonia

A

sustained contraction of mm of neck, tongue, eyes, diaphragm (hours to days)

  • haloperidol, fluphenazine

tx of dystonia: anticholinergics- diphenhydramine, benztropine, trihexphenydyl

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6
Q

tardive dyskinesia

A

grimacing and writhing tongue protrusion, mvmt of fingers and toes

  • occurs after YEARS of use of haloperidol or fluphenazine
  • can be permanent
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7
Q

acute dystonia

A

twisting and abnormal postures (hours to days)

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8
Q

hyperprolactinemia

A

seen with haloperidol, fluphenazine, ** risperidone **

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9
Q

NMS

A

neuroleptic malignant syndrome = fever, tachycardia, HTN, tremor, elevated CPK, “lead pipe” rigidity
- increased risk in haloperidol and fluphenazine

tx: supportive - discontinuiation of current medications, hydration and cooling
1. dantrolene
2. bromocriptine
3. amantadine

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10
Q

SSRI’s

A 
Fluoxetine - longest half life 
Paroxetine, 
Sertraline - GI probs 
Citalopram - fewest DDIs
Escitalopram, 
Fluvoxamine - OCD tx

common SE’s:

  • sexual dysfunction
  • Gi problems
  • insomnia, anorexia,

** increased suicidal thinking and behavior

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11
Q

OCD?

A

fluvoxamine (SSRI) - or fluoxetine, sertraline
clomipramine (TCA)
d/t pts having low levels of serotonin

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12
Q

no sexual SE’s for depression?

A

buproprion - NE and dopamine reuptake inhibitor

** increased risk of SEIZURES **
no sexual SE’s
CI in eating disorders!

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13
Q

SNRI’s

A

Venlafaxine - used for depression, anxiety, disorder

Duloxetine (cymbalta) - depression + neuropathic pain tx

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14
Q

Seratonin receptor antagonis/agonist

A

Trazodone - useful in tx of refractory major depression WITH INSOMNIA!!!

  • no sexual SE’s
  • SE: sedation, priapism
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15
Q

alpha-2 antagonist

A

Mirtazapine - useful for refractory major depression, WEIGHT GAIN

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16
Q

HETEROCYCLIC ANITDEPRESSANTS, TCA’S

A
  • Tertiary amines: highly anticholinergic (blurry eyes, pupillary dilation, more sedating, higher risk of OD)
    1. Amitriptyline - chronic pain/ migraines
    2. Imipramine - tx panic disorder
    3. Clomipramine - tx OCD
    4. Doxepin
  • Secondary amines: less anticholinergic, less sedating
    1. nortriptyline - least likely to cause OT hypoTN
    2. Despiramine

SE’s:

  • highly protein bound and lipid soluble
  • cardiotoxic: orthostatic hypoTN, dizziness, tachycardia, arrhtymias, ECG changes
  • sedation (antihistamine)
  • anticholinergic: dry mouth, constipation, urinary retention, blurred vision,
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17
Q

tx of TCA OD?

A

sodium bicarbonate IV

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18
Q

major complications of TCA’s?

A

three C’s: cardiotoxicity, convlusions, coma

anticholinergic: dry mouth, retention, fatigue, blurry vision

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19
Q

MAOIs

A

monoamine oxidase inhibitors “Phen is a tran”

  • Phenelzine
  • Tranylcypromine
  • Isocarboxazid

MOA: prevent inactivation of amines such as NE, serotonin and dopamine and tyramine

** tx of refractory depression

** CI: people with heart problems

SE’s:

    • serotonin syndrome: hyperthermia, hypertonic, rhabdo, renal problems, convulsions, coma death
    • wait two weeks to switch
    • hypertensive crisis
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20
Q

tx of enuresis?

A

TCA’s = imipramine

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21
Q

smoking cessation?

A

buproprion - also used for alcohol w/drawal

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22
Q

insomnia + depression tx?

A

** trazodone**, amitriptyline, mirtazapine

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23
Q

what to monitor when prescribe lithium?

A

Lithium levels, creatinine, thyroid levels

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24
Q

typical vs atypical antipsychotics?

A

typical - blocks dopamine receptors
* increased risk of mortality with elderly pts

atypical - block dopamine and serotonin

  • better at tx negative sx
  • lower risk of EPS sx, increased risk of metabolic syndrome
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25
Q

low potency typical antipsychotics

A

chlorpromazine - bluish skin discoloration
thioridazine

anti-HAM effects: histaminic, adrenergic, muscarinic receptors
- weight gain, hypoTN, dry mouth, tachycardia, urinary retention, blurry vision

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26
Q

mid potency typical atipsychotics

A

trifluoperazine

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27
Q

high potency typical antipsychotic

A
  • haloperidol
  • fluphenazine
    • increased action at dopamine receptors **
    • less sedation, orthostatic hypoTN, anticholinergic effects
    • greater effect at dopamine receptors thus increased EPS effects

Antidopaminergic effects:

  1. Parkinsonism - bradykinesia
  2. Akathisia - restlessness
  3. Dystonia - sustained painful contraction of mm in neck
    * * hyperprolactinemia ** decreased libido, galactorrhea, gynecomastia, impotence, amenorrhea
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28
Q

tx of EPS?

A 
benztropine (anticholinergic medication)
diphenhydramine (antihistaminergic)
amantadine 
benzodiazepines 
beta blockers

** decreased dopaminergic tone is d/t antipsychotics, by decreasing anticholinergic and anithistamine tone then they are balanced

EPS sx: dystonia (spasms), parkinsonism, akathisia

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29
Q

atypical antipsychotics

A

block both dopamine and serotonin - less likely to cause EPS, tardive diskinesia or NMS
** more effective in tx of negative sx

its atypical for closets to risper quietly from a to z

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30
Q

clozapine

A

bad:
weight gain and agranulocytosis! seizures!!
** must stop if absolute neutrophil count drops below 1500 - must have weekly blood draws for first six months
** more likely to cause DM and hypercholesterolemia as well

good:
- decreased risk of suicide, more efficacious
- less likely to cause TD

** usually reserved for pts who have failed multiple antipsychotic trials before d/t increased risk of agranulocytosis

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31
Q

Risperidone

A

increased prolactin

increased akathisia risk

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32
Q

quietiapine

A
  • lowest EPS sx

bad: sedation, orthostatic hypoTN

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33
Q

olanzapine

A

weight gain is problem!

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34
Q

ziprasidone

A

no weight gain!

bad: increased QT prolongation

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35
Q

aripiprazole

A

less potential for weight gain, less sedating!

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36
Q

typical antipsychotics less likely to cause w/g?

A

aripiprazole or ziprasidone

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37
Q

Lithium

A

USE: BPD, schizoaffective disorder, major depression, schizophrenia, tx of aggression and impulsivity

  • therapeutic range; 0.6-1.2 (lethal >2.0)
  • should have ECG, basic chemistry, thyroid function, CBC, pregnancy test
  • metabolized by kidneys: check renal function

SE’s: altered mental status, coarse tremors, convulsions, nephrogenic DI, GI disturbance, w/g, sedation, hypothyroidism
- Ebstein’s anomaly

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38
Q

mood stabilizers for BPD?

A

lithium, anticonvulsants (valproic acid, lamotrigine, carbmazepine)

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39
Q

carbamazepine

A

mixed episodes, rapid-cycling bipolar disorder

SE’s: skin rash, SJS, GI sx, drowsiness, sedation, confusion

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40
Q

Valproic acid

A

tx: mixed episodes, bipolar disorder

SE: hepatotoxicity, w/g, alopecia, teratogenic NT defects

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41
Q

gabapentin

A

used to help with anxiety and sleep as an adjunvtive with biplar disorder

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42
Q

pregabalin

A

used for GAD and fibromyalgia

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43
Q

long acting benzos

A

Diazepam (Valium) - used for detox from alcohol or for seizures

Clonazepam (Klonopin) - tx of anxiety, including panic attacks

** note: benzos can cause confusion, disinhibition, amnesia and blackouts in ederly population

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44
Q

intermediate benzos

A

Alprazolam (Xanax) - tx of anxiety, panic attacks

Lorazepam (Ativan) - tx of anxiety, panic attacks

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45
Q

Short acting benozs

A

Triazolam - used to tx insomnia
midazolam -
both primarily used in medical/surgical setting

46
Q

tx for benzo OD? benzo w/drawal?

A

flumazenil, but can cause w/drawal if used too quickly

    • benzo w/drawal can be life threatening and cause seizures
    • can have respiratory depressin OD

benzo w/drawal sx: anxiety, diaphoresis, irritability, fatigue, h/a, myalgias, “skin crawling”, tremor, seizures

47
Q

Zolpidem, Zaleplon, Eszopiclone

A

Ambient, Sonata, Lunesta - used for short term tx of insomnia

48
Q

diphenhydramine

A

“benadryl” - antihistamine - SE includes sedation, dry mouth, constipation, urinary retention, blurry vision

49
Q

Buspirone

A

anxiolytic that has action at serotonin receptor

slower onset than benzos, does not cause CNS depression

50
Q

hydroxyzine

A

antihistamine used to tx anxiety - sedation, dry mouth, constipation, urinary retentio, blurry vision

51
Q

propanolol

A

beta blocker used to tx panic attacks or performance anxiety

52
Q

dextroamphetamine

A

Adderall, dexedrine

D isomer of amphetamine, schedule II

53
Q

methylphenidate

A

Ritalin, schedule II, watch out for leukopenia, anemia, increased LFTs

54
Q

atomoxetine

A

straterra - presynaptic NE inhibitor- used to tx ADHD

55
Q

CI with seizures?

A

buproprion - can also cause hypersomnia, hyperphagia, reactive mood, leaden paralysis

56
Q

PTSD tx?

A

sertraline (or other SSRIs)

57
Q

the difft schizos

A

brief psychotic disorder: 1 day-1 mos

schizophreniform: 1 mos - 6 mos
schizophrenia: > 6 mos

schizoaffective disorder: schizophrenia + mood disorder: have continuous delusions or hallucinations for two weeks in absence of mood disorders and (meet criteria for MDD, manic or mixed episode when schizophrenia criteria are met as well) –> have mood sx present for a substantial portion of psychotic illness

mood disorder with psychotic features: have mood disorder with psychotic features, have times when psychotic features are not present, but mood disorder is

schizotypal: personality disorder: paranoid with odd magical beliefs, eccentric, lack friends
schizoid: personality disorder: w/drawn, lack of enjoyment from social interactions, emotionally restricted

best to worst: mood disorder > brief psychotic disorder> schizoaffective disorder > schizophreniform disorder > schizophrenia

58
Q

normal pressure hydrocephalus

A

NPH = shuffling gait, unable to hold urine, dementia
- CT shows increased ventricles
LP has normal opening pressure

59
Q

tx of bulemia?

A

SSRI: fluoxetine

don’t use buproprion!

can’t use SSRIs for anorexia

60
Q

cataplexy

A

sudden loss of mm tone

tx: sodium oxybate

61
Q

negativism

A

motiveless resistance to attempts to being moved (part of catotonic schizophrenia - stupor, negativism, rigidity, posturing, mutism)

62
Q

anticholinergic delerium

A

caused by anticholinergics or TCAs - OD causes clouding of consciousness, constipation, urinary retention, dry mouth, increased temp, dry flushed skin

tx: bethanechol
note: physostigmine, increases cholinergic stimulation by inhibiting cholinesterase - good for decreasing CNS sx of anticholinergics like delerium and confusion

63
Q

somatization disorder

A

pain in >4 sites, 1 neuro problem, 1 sexual problem, 1 GI problem

64
Q

atypical depression

A

eat and sleep in excess, “leaden paralysis”

65
Q

tx of PCP agitation

A

diazepam, midazolam, lorazepam

66
Q

tx of opioid detox?

A

naltrexone

67
Q

dysthmia

A

mild depression, lasting more than 2 years of depressed mood

68
Q

cyclothymia

A

more than 2 years of hypomania and depressed mood

69
Q

adjustment vs acute stress disorder

A

adjustment: behavior change as a result of stressor

70
Q

worse schizo prognosis

A

single, male, early age of onset, negative sx, family hx of schizo, poor inter functioning

note: quick onset of sx is a better prognosis, along with + sx, female and married

71
Q

tx of heroin w/drawal sx?

A

mm. aches, ab cramping, loose stools, chills, clear nasal discharge, dilated pupils (use anticholinergics i.e. diphenhydramine)

72
Q

tx of narcolepsy

A

non amphetamine stimulants: modafinil, sodium oxybate, methylphenidate

73
Q

circumstantiality

A

over inclusion of details, wanders off but eventually reaches the point

74
Q

loose associations

A

disconnected ideas

75
Q

tangentiality

A

never reaches the point

76
Q

PTSD

A

sx must be present for >1 mos ; sx are d/t life-threatening experience

vs. Acute stress disorder: like PTSD but only have sx for a short period of time sx occur for

77
Q

schizophrenia pathophysiology

A 
increased dopamine 
(possibly also increased serotonin, elevated NE, decreased GABA, decreased glutamate)

sx present >6 mos

  1. paranoid type: higher functioning, later onset - preoccupation w/ delusions and hallucinations
  2. disorganized type: poor functioning, earlier onset - disorganized speech/behavior
  3. catatonic type: motor immobility, extreme negativism/mutism or posturing
  4. residual type: prominent negative sx
78
Q

schizophrenia vs. delusional disorder:

A

schizo:
- bizarre delusions, daily functioning impaired, hallucinations, disorganized speeech/behavior, negative sx

delusional disorder:
- nonbizarre delusions, daily functioning not significantly impaired

types of delusional disorders: 
- erotomanic: delusions around love
grandiose: inflated self worth
somatic: physical delusions
persecutory
jealous delusions
mixed type delusions
79
Q

MDD

A

sx present for at least a 2 week period:

  • depressed mood
  • anhedonia
  • change in weight
  • feelings of worthlessness/guilt
  • insomnia/hypersomnia
  • psychomotor agitation/retardation
  • fatigue
  • recurrent thoughts of death/suicide

SIG E CAPS
sleep, interest, guilt, energy, concentration, appetite, psychomotor activity, suicide

pathophys: low serotonin, NE, and dopamine
* usually lasts 6-13 mos untreated

types of depression:

  1. melancholic: 40-60%: anhedonia, early morning awakening, psychomotor problems, excessive guilt, anorexia
  2. atypical: hypersomnia, hyperphagia, reactive mood, leaden paralysis
  3. catatonic: catalepsy (immobility), purposeless, extreme negativism, bizarre postures
  4. psychotic:
80
Q

BPD

A

manic episode: present for at least one week of distractibility, inflated self esteem, increased activity, decreased need for sleep, flight of ideas, pressured speech, risky activities

mixed episode: criteria for mania and MDD present every day for one week (irritibility is major mood state)

hypomanic episode: elevated, expansive mood that doesn’t cause impaired social functioning, lasts at least 4 days

BPD I: mania and major depression
BPD II: hypomania with MDD episodes

81
Q

bereavment vs. adjustment disorder

A

“simple grief” as a reaction to a major loss: lasts for two months (usually goes away in 6 mos) illusions can be common
- denial, anger, bargaining, depression, acceptance

“complicated grief” - lasts at least 6 months w/ feelings of numbness, bitterness, emptiness, trouble accepting loss, agitation

vs. depression where suicidal thoughts are present, sx last >2 mos

adjustment disorder: sx begin w/in 3 mos after event and end w/in 6 mos - have severe distress in excess and impairs daily functioning. Sx are not of bereavment. In adjustment disorder the the event is not life threatening such as divorce, loss of job, death of loved one (In PTSD or acute stress disorder, the problem is life threatening)

82
Q

dysthymic disorder

A

chronic mild depression most of the time with no discrete episodes : depressed mood for >2 years

CHASES: poor concentration, hoplessness, poor appetite/overeating, insomnia, low energy, low self-esteem

83
Q

cyclothymic disorder

A

alternating periods of hypomania and periods with mild/moderate depressive sx for >2 years

84
Q

pathophysiology of anxiety

A

increased NE, decreased GABA

85
Q

tx for social phobia?

A

paroxetine or beta blockers for performance anxiety

86
Q

egodystonic vs. egosyntonic

A

ego-dystonic: distressed by by their sx

87
Q

personality disorders

A

A: schizoid, schizotypal, paranoid (paranoid and schizotypal have increased schizo in families)
B: borderline, antisocial, historionic, narcisistic
C: avoidant, dependent, OCD

88
Q

tx of borderline?

A

psycotherapy DBT is best option and pharmacotherapy of depressive sx

89
Q

drugs for alcohol abuse?

A

disulfiram: blocks aldehyde dehydrogenase –> flushing, h/a, vomiting, SOB

Naltrexone: opoid blocker, works by decreasing craving

Acamprosate: similar to GABA

90
Q

cocaine

A

blocks dopa reuptake

  • euphoria, nausea, HR changes, dilated pupils, w/l, chills, sweating
  • w/drawal not life threatening: depression, malaise, fatigue, constricted pupils, vivid dreams
91
Q

amphetamines

A

block reuptake of dopa and NE (ex meth, ritalin, ecstasy)
sx: dilated pupils, perspiration, resp depression, chest pain
chronic use causes tooth decay “meth mouth”

92
Q

PCP

A

NMDA glutamate antagonist - can cause nystagmus, memory problems, **violence, HTN, mm. rigidity, coma, death

use lorazepam and haloperidol to tx agitation

tactile and visual hallucinations are seen in both PCP and cocaine use

93
Q

sedatives/hypnotics

A

benzos: increased GABA frequency
barbs: increased GABA duration

  • barb w/drawal can be deadly (w/drawal from sedatives can be deadly, where as stimulants often isn’t): signs of w/drawal is tonic-clonic seizures, tremors, anxiety, irritibility, HTN, hyperactivity
94
Q

opiods

A

heroin, oxycodone, codeine, detromethorphan, morphine

  • constricted pupils, slurred speech, drowsiness, nausea, vomiting, seizures, resp depression, decreased pain perception
    tx: naloxone or naltrexone (can cause bad w/drawal sx)

w/drawal is not deadly: sx are insomnia, rhinorrhea, ywaning, weakness, sweating, piloerection, dilated pupils, abdominal cramps, myalgia, tachycardia

  • Methadone: long acting opioid agonist - administered once daily - can cause QTC prolongation
  • Buprenorphine: partial opioid receptor agonist: sublingual administration “suboxone” when combined with naloxone
  • naltrexone: competitive antagonist
95
Q

LBD vs FTD

A

lewy body disease: similar to PD, caused by lew bodies, aggregation of alpha synuclein –> waxing and waning of cognition, visual hallucinations/delusions, parkinsonism

pick disease/FTD: social/personality changes, disinhibition of verbal, physical and sexual behavior, lacking empathy, poor insight, memory well preserved: d/t marked atrophy of frontal and temporal lobes

note: HD caused by atrophy of caudate
PD caused by loss of cells in substantia nigra of basal ganglia

96
Q

pseudodementia vs. true dementia

A

pseudodementia = sx of depression in elderly
- onset acute, sundowning uncommon, often answer questions” i don’t know” but can eventually answer correctly, patient is aware of their problems and worried about them, deficits improve with antidepressants

dementia = often confabulate answers (guess at them), onset is insidious, sundowning and increased confusion at night, pt is unaware of problems, cognitivie problems don’t improve with SSRIs

97
Q

tx of ADHD

A

must be present more than six months, before age 12

methylphenidate = ritalin, focalin, concerta
dextroamphetamine = dexedrine
amphetamine salts = adderall 
alpha-2 agonists: clonidine, guanfacine 
atomoxetine = non-stimulant
98
Q

asperger disorder

A

unlike autistic disorder children have normal language acquisition and cognitive development - but just have problems with social interactions

99
Q

rett disorder vs childhood disintegrative disorder

A

decreased rate of head growth and loss of learned purposeful hand skills b/w ages 5 mos - 30 mos

  • seen more in girls
  • associated with MECP2 gene mutation on x chromosome
  • “hand wringing” hand washing
  • cognitive development never goes past that of first year of life

CDD: normal develop. in first two years but loss of social skills/language/bowel skills/motor skills before age 10 - have repetitive stereotyped behaviors and impaired social interaction - more common in boys* - high rates of EEG and seizure disorders.
- Note unlike Rett head growth oesn’t slow and there are no hand mvmts present

100
Q

tourette disorder

A 
coprolalia = obscene words repeated
echolalia = exact repetition of words
  • onset before 18 years, occur almost every day for >1 year
  • sx peak around 8-12 years and often go away by adulthood
  • comorbid w/ ADHD and OCD
  • impaired dopamine regulation (maybe d/t group A beta hemolytic infection…)

tx:
- neuroleptics: risperidone, alpha 2 agonists (guanfacine, clonidine), haloperidol, pimozide

101
Q

enuresis

A

involuntary voiding of urine after age 5 - must rule out infectionsk diabetes, seizures
tx: behavior modification, antidiuretics (DDAVP), TCA’s (imipramine)

encopresis = passage of feces in inapprorpriate places by age 4
tx: bowel catharsis, stool softeners

102
Q

stranger anxiety

A

peaks around 8-12 mos

103
Q

dissociative amnesia

A

“disruption in continuity of person’s memory” - report gaps in memory of an event, especially traumatic one-

  • often unable to recall important personal infeormation: usually d/t stressful event or trauma
  • sx cause distress and impairement in functioning
  • often acute and abruptly return after minutes to days
104
Q

dissociative fugue

A
  • sudden, unexpected travel away from home, and inability to recall one’s id or past … think “fugitive”
  • unaware of amnesia and new identity, show low anxiety despite confusion
  • onset assoc. with stressful event or alcohol/head trauma

** unlike amnesia, fugue are not aware they have forgotten anything **

105
Q

dissociative identity disorder

A
  • two or more personalities; memories, habits and skills can differ.
  • more common in women; increased with severe stress
106
Q

depersonalization disorder

A
  • persistent/recurrent feelings of detachment from one’s self or environment ; common in normal people during times of stress; more common in adolescents
107
Q

somataform disorder differences

A

primary gain: internal conflicts (facitious disorder, muchausen)
secondary gain: external benefits (malingering)

  • -> Not intentionally produced: Somatoform disorders
    1. Somatization disorder: multiple nonspecific physical sx; 4 pain, 2 GI, 1 sexual, 1 neuro; sx NOT intentionally produced
  1. Conversion disorder: neurologic sx that can’t be explained; calm and unconcerned (blindness, paralysis, paresthesia)
  2. Hypochondriasis: fear of having a serious disease, persists >6 mos
  3. Body dysmorphic disorder: preoccupied with body parts they perceive as “flawed”
  4. Pain disorder: prolonged, severe discomfort w/out medical explanation; not intentionally produced. pain can be present in multiple sites - often pain in xs of the disease pathology

–> Intentionally produced sx:

  1. Factitious disorder: intentionally produce sx to assume role of “sick pt” for primary gain (Note: munchausen is primarily physical complains)
  2. Malingering: feigning physical sx to acheive personal gain
108
Q

pathophys behind explosive disorder/aggression?

A

low levels of serotonin

109
Q

refeeding syndrome after anorexia tx

A

can cause decreased levels of phosphorus, magnesium and calcium

110
Q

harmful sx of anorexia/bulemia

A

amenorrhea, cold intolerance, hypoTN, bradycardia, arrhythmia, MVP, constipation, lanugo hair, hypoTH, osteoporosis, hypo natremia/kalemia, chloremia, elevated BUN, anemia, increased GH

for bulemia see salivary gland enlargement, erosions, abrasions on dorsum of hand, petechiae, elevated bicarb, hypochloremic hypokalemic alkalosis, metabolic acidosis d/t laxative abuse

tx of anorexia: behavioral therapy, supervised w/g (SSRIs not helpful d/t low levels of tryptan)

bulemia tx: SSRIs - fluoxetine!

111
Q

zolpidem

A

sleep aid that can cause increased risk of falls in elderly

112
Q

narcolepsy

A

excessive daytime sleepiness, falling asleep at inappropriate times
* caused by low levels of hypocretin, allowing REM phenomenon to enter into wakefullness

cataplexy: sudden b/l loss of mm. tone d/t intense emotion
(vs catalepsy, unprovoked mm. rigidity)

hypnagogic hallucination: upon sleeping
hypnopompic hallucination; upon waking

tx: amphetamines, methylphenidate, modafinil, sodium oxybate

tx for cataplexy: sodium oxybate

Psychiatry Shelf (1 decks)

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