March 16 Flashcards
at what age do you give ADHD medication to a child?
6 or older
if a child below age 6 has ADHD symptoms, what should you recommend?
parent-child behavioural therapy
how do you treat an acute dystonic reaction?
anticholinergic medication
what anticholinergics are used to treat an acute dystonic reaction?
benztropine, diphenhydramine
what is dantrolene used to treat (in the setting of antipsychotic medication use)?
neuroleptic malignant syndrome
features of neuroleptic malignant syndrome?
high fever, rhabdomyolosis, muscle rigidity
what type of drug is fluoxetine?
SSRI
what changes in sleep patterns occur in major depressive disorder?
decreased REM latency and decreased slow wave sleep
which anticonvulsant is most associated with liver injury?
valproate
how long is an adequate antidepressant trial?
4-6 weeks
what is bipolar disorder I?
manic episodes with or without depressive episodes
what is bipolar 2?
at least 1 hypomanic episode and depressive episode
MOA of dextromethorphan?
activates sigma opioid recetpros but also has activity on serotonin receptors
what is dextromethorphan?
a cough suppressent
characteristics of serotonin syndrome?
- mental status changes
- autonomic dysregulation
- neuromuscular excitability
what causes the hyperthermia in serotonin syndrome?
sustained muscle contraction
which drug may cause paradoxical agitation?
benzo’s
presentation of paradoxical agitation caused by benzo?
increased agitation, confusion, aggression and disinhibition (usually within an hour of taking the benzo)
what should you do in a patient taking regular benzo’s that begins experiencing paradoxical agitation?
taper and discontinue benzo
MOA of bupropion
NE and dopamine reuptake inhibitor
does bupropion cause weight gain?
no
does bupropion cause sexual dysfunction?
no
does mirtazapine cause weight gain?
yes
does mirtazapine cause sedation?
yes
does bupropion cause sedation?
no
what is phenelzine?
a MAOi
what is venlafaxine
SNRI
venlafaxine is associated with dose dependent….
hypertension
which antipsychotic may cause agranulocytosis
clozapine
how often should you monitor bloods in a patient who has started clozapine?
every week for the first 6 months
what do you need to measure at baseline in a patient who starting a 2nd gen antipsychotic?
BMI, fasting plasma glucose and lipids, BP and waist circumferance
how often should BMI be measured in a patient on a 2nd gen antipsychotic?
monthly
how often should fasting plasma glucose and lipids, BP and waist circumferance be measured in a patient who is on a 2nd gen antipsychotic?
baseline, then 3 months, then at a year
