Management Flashcards
Low Risk Psych Mx (Exept Psychosis)
Psychologist - CBT
Possible SSRI
Lifestyle Mod - Healthy Diet and Exercise
Sleep Hygiene
Relaxation Techniques - Yoga, Mindfulness
Avoid Smoking, Caffeine, Alcohol
Support Groups - Black Dog, Beyond Blue
Crisis Plan - Suicide
High Risk Psych Mx (Exept Psychosis)
Refer to ED for Crisis Assessment Team (CAT)
Possible Admission
MHA - if Refuses
MDD Mx
Pharma - SSRI (Escitalopram or Sertraline)
- 3-4 weeks before it improves
– Change or Inc. Dose if No improvement
– ff/up after 4 weeks
- Keep meds at least 6 weeks
- SE - Weight Gain, Dec. Libido, Tiredness
Non-Pharma
- CBT - Psychologist
- Relaxation Techniques - Yoga, Mindfulness
- Lifestyle Modification - Diet, Exercise
- Sleep Hygiene
- Support Group - Beyond Blue
- Crisis Plan
Serotonin Syndrome Mx
Stop Medications
Admit, Monitor, and Refer
Cold IV fluids, Cooling Blankets
If with agitation and anxiety - Diazepam
Severe - Cyproheptadine
Acute Mania Dx
Admit in hospital for CAT Assessment
If High Risk - Continue Admission
If Low Risk - Sent Home - Community Treatment
Long Term Management
- Psychiatrist - Medication - Lithium or Olanzapine
- Psychologist - CBT
- Drug Test, Investigations
- Lifestyle Modification
- Support Groups - Beyond Blue, Black Dog
- Relaxation - Yoga, Midfullness
- Crisis
Post Partum Depression plus Psychosis Mx
Hospital Admission - Concern, MHA if refuses
Refer to Psychiatrist
- ECT
- Medications - Antidepressants and Anti Psychotics
Family Meeting
Psychologist - CBT, Talk Therapy
Lifestyle modification, Relaxation, Sleep Hygienes
Support Group - Panda, Suicide Hotline
Sleep Hygiene
Print out a fact sheet
Regular time of sleep
Environment – Dark, Quiet, leave pet outside
Keep the bed sleep and sex
Cut down Caffeine ~1-2 cup, avoid late afternoon
Relaxation Techniques
Yoga, Exercise,
Breathing Technique
Mindfulness
OCD Mx
Psychologist - CBT & Exposure Response Prevention (EBP)
Pharma - SSRI Script
Relaxation, Sleep Hygiene, Exercise, Diet
Crisis Plan – Worse and Suicidal Ideas
Support Group – OCD Australia
Quetiapine AE Mx
Investigations - FBE, LFT, FBS, TFT
Lifestyle Modifications - Diet, Exercise
Refer back to Psychiatrist to change Quetiapine to Aripiprazole
Psychologist - CBT
Alcohol Dependence Mx
Praise and Say Benefits
Inv.- FBE, LFT, FBS, ECG, vit B12
DAN - Withdrawal Symptoms
Disulfiram, Acamprosate, Naltrexone***
Thiamine
Cut Down Alcohol to Safe levels
<10Sd per week, <4 Sd per sitting
Withdrawal Sx - Tremors, Irritability
Psychologist - CBT
Lifestyle Modification - Diet and Exercise
Support Group - Alcoholic Anonymous or Alcohol and Other Drugs Services
Red flags - Withdrawal Sx
General Alcohol Advice
- Mix alcohol with non alcohol
- Avoid drinking on empty stomach
- Avoid situations or triggers
Heroin Mx
Praise and Say Benefits
Inv. - STI’s - Hep B,C, HIV, Syphilis, LFT (Sharing of Needles)
Stop Heroin and change to - Bupenorphine, Methadone - Then we taper gradually
Lifestyle Modification - Diet and Exercise
Support Group - AOD Service, Reach out Aus
Smoking Mx
Praise and Say Benefits
Stop Smoking
- Quit Date within 2 months
- Cold Turkey
Withdrawal Sx - Irritable, Tremors, Shakiness
Withdrawal Tx
- NRT - Patch, Inhalation, Lozenges
– Can use 2 forms
– CI - Heart Disease, Stroke
- Varenicline - Tablet
– Start after the quit date
– CI - Mental Health d/o, CKD
- Bupropion
– CI - Epilepsy
Psychologist - CBT
SG - Quitline
General Advice
Avoid – Alc, Coffee
Stress management
Lifestyle Modification
F/u – Respiratory problem
Family Hx
Cannabis Mx
Explain and Advice Advantage, Dependence, Withdrawal
Quit Date
Withdrawal Sx - Symptomatic Tx
Psychologist - CBT
SG - AOD Services, Reach out Aus
Family Meeting
General Advice
Avoid – Alc, Coffee
Stress management
Lifestyle Modification
