General adult Flashcards
Complications of catatonia
Dehydration
Deep vein thrombosis
Pulmonary embolism
Pneumonia
Prevalence of rapid-cycling BPAD
10-20% of all patients with BPAD
Lifetime prevalence of OCD
2-3%
Relative contra-indications to ECT
acute resp infection cardiac - MI (<3m ago), uncontrolled CHF, arrhythmia neuro - recent stroke, raised ICP, untreated cerebral aneurysm untreated phaeochromocytoma unstable major # DVT acute/impending retinal detachment
Drugs that raise seizure threshhold
Benzodiazepines
Barbituates
Anti-convulsants
UK700 trial
Failed to prove that enhanced outcomes could be
achieved under CPA by reducing case-load size.
Diagnostic Interview Schedule
Designed for use by lay interviewers
Incidence of puerperal psychosis
1-2/1000
Incidence of puerperal psychosis in women with BPAD
50%
Risk of recurrence of puerperal psychosis in subsequent pregnancies
50-80%
Antipsychotics recommended for breastfeeding
Sulpride or Olanzapine
Risk of spina bifida in valproate
1-2%
Risk of spina bifida in carbamazepine
0.5-1%
Risk of Ebstein’s anomaly in Lithium
1/1000
Antidepressants in pregnancy
Fluoxetine, amitriptyline, imipramine
Antipsychotics in pregnancy
Olanzapine, haloperidol, clozapine, chlorpromazine
Hypnotic/sedative in pregancy
Promethazine
Hypnotic/sedative in breastfeeding
Anxiety - lorazepam
Insomnia - Zolpidem
Incidence of puerperal psychosis
1/500
Serum level clozapine
350-500 ug/L
Spontaneous major malformation rate in confirmed pregnancies
2-4%
Prevalence of any personality disorder
4.4%
M:F ratio ASD
5:1
M:F ratio ADHD
2:1
M:F ratio major depression
1:2
M:F ratio bipolar I
1:1
M:F ratio agoraphobia
1:3
M:F ratio GAD, panic or phobia
1:2
M:F ratio eating disorders
1:9
M:F ratio BPD
1:3
Disulfiram
Blocks the conversion of aldehyde to acetic acid by binding irreversibly to aldehyde dehydrogenase.
Leads to symptoms such as abdominal colic, flushing, anxiety, dizziness, tachycardia, vomiting and headache.
Symptoms start 5-15 minutes after drinking alcohol and last for several hours producing symptoms of nausea and headache.
Acamprosate
A structural analogue of gamma-aminobutyric acid (GABA), leading to decreased withdrawal cravings.
Chronic overdose can result in hypercalcemia.
Transient diarrhoea most common side-effect
Incidence of post-natal depression
10%
Lifetime incidence of suicide in alcohol dependance
7%
Buproprion
Norepinephrine-dopamine reuptake inhibitor (NDRI) and nicotinic acetylcholine receptor antagonist
Buprenorphine
Partial mu opiod agonist
Half-life over 24hrs
Reduces the effect of additional street opiods
Can be combined with naloxone to reduce IV use (Suboxone)
Naltrexone
Opioid antagonist
Half-life 96hrs
Prevents relapse in drug-free patients. Also reduces both the rewarding effects of alcohol and craving for it.
Non-compliance in schizophrenia patients following discharge from hospital
25% at ten days
50% at one year
75% at 2 years
PCP intoxication
violent behavior nystagmus tachycardia hypertension anesthesia analgesia
Antipsychotics in epilepsy
Haloperidol, sulpride, trifluperazine
Antipsychotics in postural hypotension
Amisulpride
Aripiprazole
Augmentation of clozapine
Lamotrigine
Sulpride
Amisulpride
Risk factors for agranulocytosis in clozapine use
Age (increasing age increases risk)
Ethnicity (Asians are 2.4 times more likely than Caucasians)
Risk factors for neutropenia in clozapine use
Race (Afro-Caribbean 77% increase in risk)
Age (decrease in risk as age increases)
Low baseline white cell count
Risk factors for tardive dyskinesia
Advancing age Female African American Affective disorder Mental retardation Substance abuse
Risk factors for NMS
Younger age Male Physical exhaustion Dehydration or electrolyte imbalance Previous and family history of NMS Organic mental disorders Low serum iron levels Raised creatine kinase levels Comorbid substance misuse
Antidepressants in hepatic impairment
Imipramine
Paroxetine
Citalopram
Antipsychotics in hepatic impairment
Haloperidol
Amisulpride
Sulpiride
Antidepressant in HIV
citalopram
Antipsychotic in HIV
risperidone
Proportion of individuals who completed suicide who had contact with mental health services in past 12 months
28%
Proportion of “patient suicides” that occurred as inpatients
10%
Proportion of patient suicides that occurred within 3 months of discharge
18%
Proportion of patients who present to A&E with self-harm that have seen GP in past month
50%
Epilepsy and driving
Seizure free for 12 months
No seizures during the day for 3 years
