Good Sam Pimp Qs Flashcards by Julia B

Psychotic

hallucination, delusion or thought d/o

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delusion

fixed, false, idiosyncratic belief

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hallucination

sensation/perception w/o stimulus

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thought d/o

lack of connection btwn thoughts

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What neuroleptic med is derived from clozapine

olanzapine

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What study should you order before prescribing neuroleptics?

EKG (d/t risk of QTx prolongation → should be <450)

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tardive dyskinesia

abrnml uncontrollable mvt of head, face and neck

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when is pt at risk for tardive dyskinesia

after 3 mo on neuroleptic rx

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what 2 neuroleptics are least likely to cause tardive dyskinesia and EPS

Quetiapine and Clozapine

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Why is Quetiapine less likely to cause EPS?

less dopamine antagonism (targets other NTs)

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What neuroleptic is associated with the most wt gain?

Olanzaline

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2 BBW for all neuroleptics

higher risk of death in elderly, QTc prolongation

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6 SE of clozapine

agranulocytosis, heart failure, tachycardia, seizures, higher risk of death in elderly, QTc prolonfation

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How often do you check CBC for a pt on Clozapine

q wk for 1st 6 mo then q 2 wks for next 6 mo then q mo

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Neuroleptic malignant syndrome

agitation/confusion, HTN, rigidity, ↑ CK, ↑ WBC

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How do you distinguish NMS from serotonin syndrome

w/ lead pipe rigidity

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3 criteria for depression

persistently low mood, persistently low mental/physical energy, persistently low self attitude

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Best time to take sertaline

after breakfast

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Which antidepressant is best for chronic neuropathic pain?

SNRI (duloxetine but caution in liver failure)

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SNRI (venlafaxine) SE at high doses

HTN crisis

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What is trazodone

mild antidepressant that is good for sleep induction

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SE of trazodone

priapism

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Low vs high dose mirtazapine

Low (<15 mg) targets histamine, indicated for insomnia

High (>15 mg) targets serotonin and NE receptors, indicated for depression

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SSRI SE

hyponatremia (rare_

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OCD

exposure is the cure, avoidance is the disease

Hallmark of OCD

sx are egodystonic (pt has good insight but x reporting is dec d/t shame)

tx for OCD

exposure response prevention therapy + SSRI

5 sx of PTSD

exposure, intrusion sx, avoidance, behavior/mood changes, hyperarousal

tx for PTSD

CBT, SSRIs, prazosin (or clonidine)

2 SSRI that are FDA approved to treat PTSD

sertaline, paroxetine

off label use of gabapentin

anxiety

2 psych indications for propranolol

panic attacks, performance anxiety

SE of propranolol

agranulocytosis

3 tx for depressive episodes in bipolar d/o

quetiapine, olanzapine, lurasidone

unique SE of depakote (valproic acid

pancreatitis

2 indications for carbamezapine

epilepsy, bipolar d/o

SE of carbamezapine

agranulocytosis

diff btwn heroin and buprenorphine

buprenorphine is a partial mu agonist heroin is a full agonist

danger of buprenorphine

precipitating withdrawal

3 benzos indicated for alc withdrawal and why

lorazepam, oxazepam, temazepam metabolized via glucuronidation not via liver

how many calories qualifies as a binge

2000

most deadly psych d/o

anorexia

orthorexia

obsessing over eating foods that pt thinks are healthy

CXR shows cardiomegaly → what psych d/o should be on ddx

purging (specifically ipecac abuse - med that causes vomiting)

signs of purging on BMP

hypokalemia | ↑ CO2

psych d/o on ddx of pt c/o ortho hypotension

eating d/o

what to watch w/ re-feeding syndrome

phosphate, potassium, and magnesium levels

HM biochem feature of refeeding syndrome

hypophosphataemia

tx for borderline personality d/o

dialectical behavorial tx

delirium

fluctulating levels of consciusness

consciousness

quality of mental life that varies on sepctrum from comatose to alert

dementia

progressive deterioration/impairment in global intellectual fn from previously established baseline level

greatest risk of falls in elderly

benzos

off label use of mirtazapine

nausea in elderly

best tx for hallucinations secondary to parkinson's dz

quetiapine

first line tx for agitation sexondary to dementia

SSRI

first line tx for agitation secondary to delirium

non-pharm interventions (2nd line = trazodone)

when to treat dementia

when it interferes w/ IASLs

what is rivastigmine

acetylcholinesterase inhibitor (other is donepazil) indicated for dementia tx

Why is rivastigminr CI in pt on beta blockers

risk of bradycardia

how to differentiate Alzheimer's from vascular dementia

vascular is stepwise, Alzheimer's is progressive

Why not give elderly pts benzos

inc agitation, fall risk, cognitive decline

Reversible cause of dementia

hypothyprod, B12 or folate deficiency, syphilis (RPR screening, requires confirmation)

Which 2 anticonvulsants increase SI

lamotrigine, topiramate

which anticonvulsants cause weight loss

zonisamide

Capacity

ability to: express/sustain a choice understand relevant info appreciate situation and consequences manipulate info readily