mar 17 Flashcards
how do you treat akathisia caused by an antipsychotic?
Reduce antipsychotic dose and administer beta blocker, benzodiazapene, or benztropine
what kind of symptoms occur in conversion disorder?
neurological
characteristics of somatic symptom disorder?
1 or more unexplained symptoms with excessive worry, thoughts/anxiety, and behaviours in response to symptoms
what is the first line medication for narcolepsy
modafenil
what is ziprasadone?
2nd gen antipsychotic
which of the 2nd generation antipsychotics has a low risk of metabolic side effects?
ziprasadone
which of the 2nd generation antipsychotics has the highest risk of metabolic side effects?
olanzapine
what is fluphenazine?
1st gen antipsychotic
what is phenelzine?
an MAOi
what is cosyntropin
synthetic form of ACTH
what test should you do in someone you suspect has addisons disease?
cosyntropin stimulation test - then measure cortisol
symptoms of antidepressant discontinuation syndrome?
flulike symptoms (myalgias, chills, headache, rinorrhea), insommnia, tremor, parasthesias, etc.
what is a functional tremor
a functional movement disorder - involuntary movements that are not consistent with a neurological cause
functional tremors improve with …
distraction
do functional tremors tend to come on gradually or abruptly?
abruptly
A drug rash is a common side effect of which bipolar treatment?
lamotragine
Someone on lamotragine develops a rash, what should you do?
Discontinue lamotragine - dont risk it turning into SJS
at what lithium level should a patient undergo hemodyalsis?
> 2.5 mEg/L with prominent signs of toxicity OR > 4 or creatine > 2 even with no symptoms
is activated charcoal useful in treating lithium toxicity?
no
A patient is being treated with an opioid drug. How can the physician decrease prescription misuse?
- checking prescription drug monitoring data at each visit
- random urine screening
- and frequent follow-up
do long acting forms of opioids help prevent misuse as compared to short acting?
no - also increased mortality
low levels of 5-HIAA in the CSF are associated with…
suicidal behaviour
5-HIAA is a metabolite of…
serotonin
3Hz spikes on EEG is characteristic of…
absence seizures
CSF 14-3-3 proteins =
creutzfeild jakob
Generalized slowing with perioidic sharp wave complexes on EEG =
creutzfeild jakob
low concentration of hypocretin (orexin) in the CSF is found in which conditions?
narcolepsy
signs/symptoms of neuroleptic malignant syndrome?
- fever
- altered mental status
- generalized muscle rigidity
- autonomic instability
- elevated CK and renal failure
