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Mental Health > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what drug class is associated with the highest risk of withdrawal symptoms → leading to seizures + death?

A

benzos

never stop cold turkey

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2
Q

Short-acting sedative-hypnotic sleep agents act on what?

A

gaba

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3
Q

meds to treat dramatic shifts in emotions, moods + energy levels. what’s an example?

A

mood stabilizers

ex: lithium

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4
Q

therapeutic + toxicity levels for lithium.

A

therapeutic: 0.6-1.2
toxicity: > 1.5

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5
Q

SE of lithium toxicity (early) (2)

A

tremors + diarrhea

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6
Q

SE of lithium toxicity (late)

A

cognitive changes

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7
Q

what should be monitored with lithium use?

A

1, thyroid fxn

  1. kidney fxn
  2. diet + fluids (remember that lithium acts as a salt, so dehydration could cause toxicity)
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8
Q

what SE should we teach about with anticonvulsants?

A

SJS!

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9
Q

what is 1st line tx for depression?

A

SSRIs

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10
Q

remeron can help with what?

A

appetite

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11
Q

2 main SE of antipsychotics (1st gen)

A
  1. EPS
  2. tardive dyskinesia (b/c these meds are working on dopamine = dopaminergic action) *

KNOW*

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12
Q

what kind of testing/monitoring should be used for antipsychotics (1st gen)?

A

AIMS testing (Abnormal Involuntary Movement Scale) + ongoing general monitoring

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13
Q

SE of antipsychotics (2nd gen)

A
  1. metabolic side effects (DM, hyperlipidemia, BMI changes)
  2. agranulocytosis → infection risk (specifically clozapine)
  • limited risk of EPS *
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14
Q

what drugs decrease symptomatology w/o effects on movement?

A

2nd gen antipsychotics

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15
Q

Primary NTs associated with ADHD drugs

A

norepi + dopamine

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16
Q

1st line tx/gold standard (for post school-age children) with ADHD

A

stimulants

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17
Q

name some SE of stimulant ADHD meds (5)

A
  1. decreased appetite
  2. insomnia
  3. increased dopamine → psychosis risk
  4. alterations in anxiety
  5. “zombie look”
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18
Q

what are 3 examples of psychiatric medications used in an emergency situation?

A

haloperidol (Haldol), olanzapine (Zyprexa) + ziprasidone (Geodon)

HOZ

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19
Q

Dr. T mentioned to NOT give 2 drugs together b/c of risk of cardiopulmonary arrest (give 1 hr apart). what are they?

A

olanzapine + lorazepam

Zyprexa + Ativan

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20
Q

acetylcholine is associated mostly with which 2 things?

A

memory

movement

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21
Q

principle NT associated with alzheimer’s

A

acetylcholine

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22
Q

dopamine is associated mostly with which 2 things?

A

movement

reward center

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23
Q

too little dopamine is associated with which disorder?

what about too MUCH dopamine?

A

too little: parkinson’s

too much: schizophrenia

24
Q

norepinephrine is associated mostly with which 2 things?

A

alertness

awake/arousal

25
Q

too little norepinephrine is associated with which condition?

A

depression

26
Q

serotonin is associated mostly with which 2 things?

A

mood

sleep

27
Q

what is the principle NT associated with depression + stress-related disorders?

A

serotonin

28
Q

gaba is associated mostly with which 2 things?

A

awake/arousal

calm

29
Q

which NT is mostly associated with anxiety disorders?

A

gaba

30
Q

glutamate is associated mostly with which 2 things?

A

excitatory

memory

31
Q

which NT is mostly associated with schizophrenia?

A

glutamate (also dopamine)

32
Q

what medication class is decreasing dopamine → improves positive symptoms

A

antipsychotics

33
Q

what things should we monitor for with antipsychotic use?

A

movement disorders -1st gen

difficulty eating, breathing, talking, muscle changes (tightness, tremors), pain, dystonia

metabolic issues -2nd gen
agranulocytosis -clozapine

34
Q

what is the monitoring protocol for clozapine?

A

1st 6 months: weekly blood monitoring f
2nd 6 months: biweekly monitoring

(for agranulocytosis)

35
Q

AE of SSRIs (4)

A
  1. sexual dysfxn
  2. insomnia
  3. tremors
  4. N/V
36
Q

AE of SNRIs (5)

A
  1. anxiety at start of therapy
  2. tachycardia
  3. dry mouth
  4. N/V
  5. fatigue
37
Q

AE of TCAs (2)

A
  1. anticholinergic SE

2. suicidal thoughts

38
Q

best patient education for MAOIs

A

dietary: avoidance of tyramine foods

39
Q

how long should benzos be used? ideally

A

SHORT periods of time

40
Q

things to monitor for with benzos

A
  1. sedation
  2. CNS effects
  3. safety
  4. dependence
  5. overdose
41
Q

what drug class can be used for PRN anxiety management? (safer/less dependence risk option)

A

antihistamines (hydroxyzine)

still some sedation, but not as pronounced as benzos

42
Q

neuroleptic malignant syndrome is associated with which drug class?

A

antipsychotics

43
Q

SE of neuroleptic malignant syndrome (4)

A
  1. fever
  2. changes in LOC
  3. HTN
  4. sweating
44
Q

what 3 scenarios can cause neuroleptic malignant syndrome?

A
  1. titrating too quickly
  2. switching meds
  3. too high doses
45
Q

serotonin syndrome is associated with which drug class?

A

anything that acts on serotonin and creates an environment where we have more of it

(SSRIs, SNRIs)

46
Q

SE of serotonin syndrome (5)

A
  1. mental status change
  2. hyperactivity
  3. tremors
  4. neuromuscular abnormalities
  5. GI

too much serotonin

47
Q

tx for serotonin syndrome

A
  1. stop med
  2. treat symptoms
  3. supportive therapies for the SE
48
Q

what is the best model of care?

A

integrated

49
Q

this model is patient centered and holistic. adjectives to describe it are empowered, strengths-based, peer support, respect, responsibility, hope….

A

recovery model

50
Q

what are our vulnerable populations in mental health care?

A

older adults + children

51
Q

reasons for involuntary admission

A
  1. Mentally ill
  2. Danger to self or others
  3. Cannot meet basic necessities
  4. Cognitive or substance challenges → may have to get court-ordered treatment

Does NOT mean patient loses their rights

52
Q

name these levels of prevention:

  • ongoing management
  • screening measures
  • education on mental health and wellness before any symptomatology
A
  • tertiary
  • secondary
  • primary (our goal)
53
Q

what is the evidenced-based 1st line tx for anxiety + depression? (not pharmacology)

A

cognitive behavioral treatment (CBT)

54
Q

describe CBT

A

Exploring ways of thinking about problems and associated behaviors → transform maladaptive behaviors into healthy coping strategies

55
Q

a person’s ability to cope + strategies they use to cope is referring to what?

A

resiliency

56
Q

what should we be assessing with hallucinations?

A
  1. are they command hallucinations? (telling patient to do something specific)
  2. ask for content

Mental Health (2 decks)

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