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Psychopharm 3 > ECT drugs > Flashcards

ECT drugs Flashcards

1
Q

Like Mario & Luigi…

A

Bini & Cerletti! Inventors of ECT

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2
Q

ECT has been used for over…

A

50 Years!

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3
Q

T/F The APA considers ECT safe.

A

TRUE

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4
Q

They believed that these two couldn’t coexist together, so they’d force one out:

A

Schizophrenia & Epilepsy

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5
Q

What reduced the use of EXT?

A

Criticism & Psyhotropic Drugs

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6
Q

ECT is still a useful treatment for:

A

Depression - when everything else is ineffective.

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7
Q

ECT can also be used to help people suffering:

A

Suicidal ideation
Mania
Catatonia
& Some types of schizophrenia

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8
Q

How many treatments does the patient normally receive?

A

6-12

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9
Q

How long is electric current passed through the brain?

A

.5-2 seconds

Not the current that treats, but the seizure activity!

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10
Q

Current desirably induces a…

A

Grand Mal Seizure lasting 30-60 seconds

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11
Q

ECT patient’s shouldn’t take these drugs. Why?

A

Benzos - raise seizure threshold

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12
Q

Today, ECT is administered under:

A

Short-term anesthesia, modifying seizure activity

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13
Q

The five drugs used in ECT are: (msagp)

A 
methohexital
succinylcholine
atropine
glycopyrolate
propofol
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14
Q

Methohexital is a very…

A

Short-acting barbiturate

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15
Q

Methohexital is used here to…

A

Anesthetize patient & reduce pre-treatment anxiety

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16
Q

Methohexital is administered:

A

IV by anesthesiologist

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17
Q

Dose for methohexital in ECT?

A

1.5mg per kg of body weight (50-120)

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18
Q

Methohexital works quickly by:

A

Passing blood brain barrier and quickly depressing CNS

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19
Q

Duration of the effect of methohexital?

A

5-7 minutes! ACT FAST!

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20
Q

Methohexital is excreted by…half-life?

A

Urine - half life of 3-8 hours.

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21
Q

Major side effects of methohexital?

A 
Resp. depression
Hypotension
Myocardial depression
Anaphylactic reactions
Dyspnea
Prolonged unconsciousness
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22
Q

Minor side effects?

A

N/V
Headache/restlessness
Skin rash
HICCUPS

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23
Q

Methohexital interacts with..

A

Other CNS depressions

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24
Q

Methohexital can cause hypotension when mixed with…

A

Furosemide - diuretic

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25
Q

This next drug killed MJ!

A

Propofol

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26
Q

Propofol is used as an alternative to…

A

Methohexital

27
Q

Propofol produces effects in only..

A

40 seconds

28
Q

Usual dose of propofol?

A

.75-1.5mg per kg of body weight

29
Q

Duration of effect of propofol?

A

5-10 minutes

30
Q

If we were to put someone into a drug induced coma, we would do so with:

A

Propofol

31
Q

Propofol is beneficial over methohexital because it is less likely to:

A

Produce cardiovascular & N/V effects

32
Q

Propofol is known to affect the length of seizure by:

A

Reducing it!

33
Q

Propofol also _____ _______ @ injexn site.

A

Causes pain

34
Q

Propofol, while a better symptom profile may interact with _____ ________ and produce:

A

Irreversible MAOI’s hyper/hypotension

35
Q

We should wait how long between MAOI & ECT?

A

Couple of weeks

36
Q

This next drug is used because to control muscle contraction during seizure.

A

Succinylcholine

37
Q

Succinylcholine is an:

A

Ultrashort acting neuromuscular blocker

38
Q

The paralysis caused by succinylcholine is effective in:

A

Preventing or significantly reducing muscle contractions with seizure

39
Q

T/F Succinylcholine effects seizure activity in brain.

A

FALSE - no changes

40
Q

Dose for succinylcholine? (Small)

A

0.6mg per kg of body weight

41
Q

Succinylcholine is given Before or After methohexital?

A

AFTER - One minute!!!

42
Q

Succinylcholine is effective by…

A

Interfering with action of acetylcholine in muscle cells.

43
Q

Initial stimulation by succinylcholine causes.

A

Depolraizations - which then develop into paralysis as binding to receptor sites prevents further depolarization.

44
Q

Complete paralysis effect in…

A

30-60 seconds

45
Q

T/F Succinylcholine can be reversed by other drugs.

A

FALSE - Cannot be reversed

46
Q

Side effects of succinylcholine include:

A 
Extensions of paralysis
Prolonged respiratory depression & apnea
Cardiac arrest & changes in rhythm
Hypotension
Skin rashes!
47
Q

These drugs can prolong paralysis with succinylcholine:

A

Lithium
Promazine (Phenothiazine)
Furosemide
Phenelzine (Irrev MAOI)

48
Q

This drug is used to decrease production of saliva & respiratory secretions. Dry you out. Like a bone.

A

Atropine

49
Q

In addition to drying out, it is useful to decrease…

A

potential of CV depression

50
Q

Atropine is given by..and when?

A

SQ or IM 1/2 hour to 1 hour before

51
Q

Dose range is…(small)

A

.4-.6mg

52
Q

Duration of effect of atropine?

A

4 hours

53
Q

Common side effects of atropine?

A

Anticholinergic effects

54
Q

Atropine will potentiate other drugs with:

A

Anticholinergic properties (psych meds & antihistamines)

55
Q

An alternate to atropine?

A

Glycopyrolate

56
Q

In addition to drying saliva & secretions it will prevent:

A

Bradycardia

57
Q

Glycopyrolate can be given…

A

IM or IV

58
Q

IV onset is within:

A

1 minute

59
Q

IM onset is within..

A

20-40 minutes, peaking 30-35

60
Q

Dose range (sooo small)

A

.1-.4mg

61
Q

Compared to atropine, glycopyrolates action is:

A

Longer

62
Q

The benefit of being longer is:

A

Longer time frame of protection against bradycardia.

63
Q

Side effects of glycopyrolate?

A

Anticholinergic Sfx

64
Q

Glycopyrolate will also:

A

Interact and potentiate anticholinergic effects of other drugs.

Psychopharm 3 (13 decks)

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