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psych rotation > first line, second line > Flashcards

first line, second line Flashcards

1
Q

ASD

A
  • family education, behavior shaping, speech therapy, occupational therapy, educational planning
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2
Q

ADHD

A
  • first - amphetamine, methylphenidate
  • second - atomoxetine
  • third - bupropion, imipramine
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3
Q

tourette’s

A
  • first - controversial, some say clonidine/guanfacine, while others prefer SGAs.
  • second - FGA (haloperidol)
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4
Q

schizoaffective

A
  • first - SGA
  • second - mood stabilizer for mania
  • third - SSRI, only in predominantly depression if SGA doesn’t stabilize mood
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5
Q

schizophrenia

A
  • first - SGA

- second - FGA

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6
Q

bipolar (child)

A
  • first - lithium only drug approved for 12-18 years old
  • second - lithium, carbamazepine, valproate
  • third - SGA
  • fourth - SSRIs/bupropion - be careful!
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7
Q

cyclothymia

A
  • first - lithium, valproate

- second - SGAs

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8
Q

MDD w/psychotic features

A
  • first - SSRI + SGA

- second - switch SSRI for different antidepressant

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9
Q

MDD

A
  • first - SSRI, SNRI, bupropion, mirtazipine
  • second - TCA
  • third - MAOI
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10
Q

dysthymia

A
  • first - SSRI, SNRI
  • second - TCA
  • third - MAOI
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11
Q

premenstrual dysphoric disorder

A
  • first - SSRI
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12
Q

panic disorder

A
  • first - SSRI, SNRI
  • second - CBT
  • short term - benzo, beta-blocker
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13
Q

specific phobia

A
  • first - psychotherapy (CBT with exposure)

- second - bentos acutely, SSRIs

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14
Q

separation anxiety disorder

A
  • first - psychotherapeutic modalities directed toward individual, family, and school.
  • second - SSRIs, never monotherapy
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15
Q

social anxiety disorder

A
  • first - CBT
  • short term - benzos/beta blockers
  • long term - SSRI/SNRI
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16
Q

GAD

A
  • first - CBT + SSRI

- second - switch SSRI for SNRI or TCA

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17
Q

OCD

A
  • CBT (exposure/response) + SSRI
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18
Q

PTSD

A
  • first - sertraline or paroxetine
  • second - prazosin for hyperarrousal
  • third - SGAs
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19
Q

adjustment disorder

A
  • first - supportive psychotherapy
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20
Q

acute stress disorder

A
  • first - support

- second - sedatives or hypnotics

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21
Q

dissociated identity disorder

A
  • first - psychodynamic psychotherapy

- second - SSRIs

22
Q

conversion disorder

A
  • first - reassurance and education

- second - CBT/PT

23
Q

illness anxiety disorder

A
  • first - schedule frequent, regular clinic appointments to assure complaint is taken seriously
  • supportive counseling
24
Q

somatic symptom disorder

A
  • validate
  • biofeeback for muscle pain and headaches
  • SSRI/TCA
25
factitious disorder
- form alliance with patient
26
bulimia nervosa
- nutrition rehab +CBT + SSRI
27
anorexia nervosa
- nutritional rehab, inpatient - psychotherapy not enough - family treatment - limited evidence for olanzapine
28
enuresis
- psychoeducation, supportive psychotherapy, behavior modification - DDAVP, only for 7 years and older
29
insomnia disorder
- sleep hygiene education, relaxation training, CBT | - ramelteon, trazodone, benzo receptor agonists
30
non-REM sleep terror
- protect child, do nothing
31
conduct disorder
- MST
32
alcohol use disorder
- wernicke - thiamine - craving - naltrexone, acamprosate - behavior - disulfiram
33
cocaine use disorder
- narcotics anonymous
34
opioid withdrawal
- clonidine can reduce withdrawal symptoms, but not cravings - naltrexone can make withdrawal symptoms worse - methadone can be used in place of or in addition to clonidine - buprenorphen can be used instead of methadone
35
tobacco use disorder
- NRT | - buproprion, varenicline
36
PCP intoxication
- keep safe - no antipsychotics - benzos are safe
37
alcohol withdrawal
- high dose benzo, slowly taper
38
benzo withdrawal
- benzo, slowly taper
39
amphetamine intoxication
- no treatment | - time, keep safe
40
delirium
- behavioral intervention - antipsychotic, be careful with long QTc or torsade - avoid benzos, unless benzo or alcohol withdrawal
41
neurocognitive disorders
- workup for medical causes - alzheimers - cortical atrophy, ACh inhibitors - vascular - deep white matter infarcts - picks - frontotemporal atrophy - hydrocephalus - lumbar puncture - aggression - low dose antipsychotics - avoid benzos
42
schizoid personality disorder
nothing
43
anti-social personality disorder
SSRIs and mood stabilizers for aggression
44
avoidant personality disorder
- psychodynamic or CBT
45
OCPD
- psychodynamic psychotherapy
46
histrionic personality disorder
- group therapy
47
dependent personality disorder
- psychodynamic psychotherapy
48
schizotypal personality disorder
- low dose antipsychotics if needed
49
narcissistic personality disorder
- group therapy
50
borderline
- DBT

psych rotation (2 decks)

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