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Mental Health > Exam 1:Mental Health > Flashcards

Exam 1:Mental Health Flashcards

1
Q

Non-addictive
-Long-term treatment
- 2-4 weeks to be effective
- Not for acute anxiety
- Risk for serotonin syndrome
- Risk for orthostatic hypotension
- Risk for older adults bc it can cause delirium

A

Buspirone

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2
Q

Major Depressive Disorder

A

Persistent dysphoria
Constant state of unhappiness
Guilt
Appetite
Suicidal thoughts
Psychomotor retardation
Slow movement
Interest lost
Lost of pleasure and not interested in things they use to enjoy
Concentration diminished
Energy decreased
Sleep disturbances
Insomnia or hypersomnia

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3
Q
  • Physical exam
    Mimic depression
A

Hypothyroidism & vitamin D deficiency

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4
Q
  • Depression scale
A

-Help screen potential depression
-Can be used to refer patient to someone else
-H/O previous episodes of depression; previous coping skills
-Analyze if coping skills are effective
-Support systems
-Cultural factors

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5
Q

*Outcomes For depression

A

-Safety first
-Patient will identify 3 coping mechanisms
- Patient will name 2 persons of support when suicidal
- Patient will gain 5 lb
- Patient will sleep 6-8 hours per night

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6
Q
  • Process:Implementation For depression
A

-Therapeutic silence
Offering self
-Be a source of support
-Ensure adequate food, sleep, ALDs, and elimination needs
Make sure they use the bathroom
-Precautionary measures for suicide
-Environmental check
-Medication education
-Illness that patient has no control over
- Teach self-help strategies

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7
Q

Interdisciplinary Tx : Depression

A

-Milieu
- Make sure environmental is low stimuli
- Psychotherapy
- Usuall CBT is first
Mindfulness-CBT
- Meditation

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8
Q

Pharmacological Tx; Depression

A

Antidepressants
-SSRI
– SNRI
- Trazodone- TCA
- MAOIS
-Buproporin
Ketamine

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9
Q

Antidepressants

A
  • Black box warning with increase risk of suicide within first few weeks of meds
  • Target mood symptoms
  • Do not target suicide
  • Energy will increase and may have energy to suicide
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10
Q

SSRIs: Citalop Tx;

A
  • Useful of depression with anxiety, panic disorder, ptsd, ocd, bulimia
    -2 to 3 weeks for full effect
  • Prohibits reuptake of serotonin
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11
Q

SSRI : Adverse effects

A

-Sleep disturbance
- Sexual dysfunction
-Tension headaches
-Reduced appetite
-Hyponatremia
- Headache
- Steven johnson syndrome

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12
Q

SSRI C; Serotonin Syndrome

A
  • Shivering
  • Hyperreflexia
  • Increased temp
  • VS instability
  • Encephalopathy
  • Restlessness/Sweating
  • Abdominal pain
    -Increased bleeding tendencies
  • Do not administer with NSAIDS or Warfarin
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13
Q

Trazodone

A
  • Tx for depression / Insomnia
  • Block reuptake of serotonin
  • Watch for Serotonin syndrome
  • Extremely sedating
  • Can be given with SSRI / SNRI and other meds
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14
Q

Trazodone : adverse effects

A
  • Priapism
  • Painful erect penis
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15
Q

Tricyclics(TCAs):Tx depression/Nerve pain

A

-4-8 weeks for full effects
Anticholinergic Side Effects:
- Dry mouth, blurry vision, tachycardia, constipation, urinary retention, esophageal reflux, photophobia, sexual dysfunction
- Urinary retention(Assume kidneys are not working any more)

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16
Q

TCAs : (Amitriptyline) Adverse Effects

A
  • Orthostatic hypotension
  • Easy to become addicted and lethal
  • High risk for falls
    -Dysrhythmias
    -Myocardial infarction
  • Heart block
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17
Q

TCAs: contraindications

A

Recent mi
Narrow-angle glaucoma
Benign prostatic
Hypertrophy
Seizures

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18
Q

MAOIs

A
  • R/t;serotonins syndrome
    -Always check BP
    Hypertensive crisis [BP 180/100]
  • Severe HA or blurry vision
  • Chest pain, tachycardia
  • SOB
    -Diaphoresis, anxiety
  • Mental status change, confusion, N/
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19
Q

(MAOIs): Tyramine foods to avoid:

A
  • Avocados, figs, fermented, smoked, cured meat, fish
  • Bologna, pepperoni, salami
  • Almost all cheese
    Yeast extract, some beers, protein supplements
  • Shrimp paste, soy sauce
  • Red wine
  • No chocolate
  • No caffeine
    -No ripe bananas
20
Q

MAOIs : Contraindications

A

CV disease
HTN, CHF
Liver disease
Recurrent or severe Headaches
Recent surgery

21
Q

bupropion Tx: Depression / cessation

A
  • Prevention of seasonal pattern depression
  • Adverse Effects:
  • Appetite suppression
    Seizures
22
Q

Ketamine:

A
  • Anesthetic
  • Target suicidal ideation
    -Few day activation
    -Fades in a couple days
    Patients have to go in for regular treatment
23
Q

Brain Stimulation Therapies:

A
  • Electroconvulsive therapy
    —-Major depressive disorder/ Schizophrenia /Acute mania
    C; - Memory Loss
  • Not an option for CV disease
24
Q

Brain Stimulation Therapies:

A
  • Vagus Nerve Stimulation
  • Transcranial Magnetic Stimulation
    —-Generate impulse into brain
  • Stimulate neurotransmitters so that it is readily available
25
Q

Brain Stimulation Therapies: Invasive

A
  • Deep Brain Stim
  • used for Parkinson’s disease
26
Q

Acute Anxiety:

A

Threaten sense of security
- Stressor
Ex: before surgery

27
Q

Mild anxiety:

A

-Mild irritability
- Restlessness

28
Q

moderate anxiety:

A

Narrowed perceptual field
- Altered ability to learn
Physical characteristics
- Muscle tension
- Pounding heart
- Increase RR, HR
Somatic symptoms
- Use of bathroom a lot before test
- Voice tremors

29
Q

Severe anxiety:

A

Greatly reduced perceptual field
- Overly focused
- Attend to superficial, scattered details
- Unable to learn
- Physical characteristics:
- Panic: more psychotic
Erratic, impulsive, and may hallucinate

30
Q

Panic Disorders:

A
  • Recurrent Anticipatory anxiety and unexpected panic attacks
  • Panic attack
  • Lasts 1 - 30 min
  • Sudden onset of fear or apprehension
  • Not always in response to an acute stressor
31
Q

Generalized Anxiety Disorder:

A
  • Excessive anxiety and worry about a number of events and activities
  • Worried about everything
32
Q

Body Dysmorphic Disorder:

A

-Preoccupation with an imagined “defective body part”
- Usually start age at 20
- Symptoms:
Constantly grooming
Checking mirrors
- Going through multiple surgeries

33
Q

Hoarding Disorder:

A

Medication does not help
Tx; How we cope

34
Q

Sublimation:

A
  • Unconscious process to substitute constructive and acceptable activities for a strong impulse
35
Q

Reaction Formation:

A
  • Unacceptable feelings are kept out of awareness by doing the opposite:
  • Ex: Gay who is homophobic
36
Q

Interdisciplinary Tx; anxiety

A

Psychotherapy
Most evidence based
- Focus on identifying cognitive distortions and change them
- Acceptance and committed therapy
Help to accept anxiety is normal

37
Q

Behavioral Therapy : Anxiety

A

Aversion therapy
- Flooding
Systematic desensitization
- Person who is systematically exposed to a situation they are afraid of
- Exposure and response prevention
- Repetition exposed to phobia until they are not scared
- Modeling
- Thought stopping

38
Q

MAOIs Cause;

A

HTN crisis

39
Q

SSRIs : SHIVERS

A

S- shivering
H- hyperflexia
I- Increased Temp
V- V/S instability
E- Encephalopathy
R- Restlessness
S- Sweating

40
Q

Benzodiazepines good for?

A

-panic attacks
- Short-term treatment
-Tolerance develops
- Withdrawal symptoms

41
Q

Benzodiazepines Cause;

A

-Addiction
Side Effects:
-Impaired judgment
- Antidote
- Paradoxical effect:

42
Q

Benzodiazepines :Antidote

A

flumazenil

43
Q

Antihistamines Good Tx for ?

A

-Good for those with substance abuse
- Good alternative for benzodiazepine
(Short term use only)

44
Q

Body Dysmorphic Disorder Tx:

A

SSRI with combination with therapy

45
Q

MAOIs

A

-Up to 5 Weeks (wash out) if patient is changing from SSRI to MAOIs

46
Q
A

Mental Health (1 decks)

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