misc Flashcards
Patients taking selegiline may test positive for
Methamphetamine
Managing Lithium side effects:
GI issues: change to longer acting preparation or use lithium citrate syrup
Hypothyroidism: Treat with thyroid hormone
Tremor: treat with propranolol or primidone
Anorexic patient complains of constipation, what med do you give?
Do not give a laxative (lactulose, senna, magnesium hydroxide). Give a stool softener (docusate)
Which is a good hypnotic for the elderly
Ramelteon
When detoxing an alcoholic who has liver impairment, which is the best medication?
Ativan or Oxazepam (they’re easy on the liver)
What does Lithium do to the parathyroid gland?
Hyperparathyroidism
What’s the max dose of focalin for kids age 6 to 17
20mg
PCP intoxication signs
Impulsiveness, unpredictable, psychomotor agitation, aggression, HTN, tachy, ataxia, muscle rigidity, seizures. It’s the only drug that can cause VERTICAL nystagmus, but it can also cause horizontal or rotary nystagmus.
Dissociative (psychogenic) amnesia includes loss of
autobiographical memory, sometimes with preserved ability for new learning
What meds can cause agranulocytosis
Mirtazapine (and carbamazepine and Clozaril)
Sensitivity and specificity
“Sensitivity” has an “n” in it and so does the word “in”
Sensitivity is to rule in a disease (true positive)
Selegiline absolute contraindications
Pheochromocytoma and surgery
What is the primary, direct cause of neuron loss in an ischemic stroke
Excessive increases in excitatory neurotransmitters
Drugs the autoinduce their own metabolism
Carbamazepine, cyclophosphamide, theophylline, ifosfamide, aminoglutethimide
Custody of children cases must be determined by
A forensic evaluator
Somatic symptom disorder
Somatic symptoms that are distressing and accompanied by excessive thoughts and fears.
These meds should be discontinued before ECT because they can interfere with the effects
Lithium, benzos, anticonvulsants, and theophylline
Giving antidepressants in the 3rd trimesters can have what risk for the baby
Discontinuation syndrome
Criteria for Alcohol Use Disorder, Severe
At least 6 items are present
Carbamazepine is metabolized in the liver by
CYP34A
GHB (Xyrem)
A schedule III med used for cataplexy in narcolepsy
Yohimbine
An alpha agonist that can help men with SSRI induced sexual dysfunction, but also causes anxiety
Fluoxetine increases the drug levels of
TCAs, thioridazine, benzos, carbamazepine, phenytoin, warfarin, and bupropion
Sumatriptan
Used to treat migraine and cluster headaches. It’s a 5HT1D and 5HT1B agonist
When does someone usually have their first panic attack
Out of the blue while doing everyday things
The Maudsley Model is used to treat
Anorexia
Folate deficiency can result in
Macrocytic anemia
1mg of Xanax = __mg of Ativan
2
Antidote of benzo overdose
Flumazenil
Zaleplon
It’s the only hypnotic that can be taken in the middle of the night without causing significant grogginess in the morning. It has a short half-life, 1 or 2 hours. (“If you buy her a ring at Zales, you’ll have a short married life).
How do you add lamotrigine for a patient who is on valproate
Halve the starting dose because valproate doubles the level of lamotrigine
For borderlines, the 1st line medication treatment for impulsivity and instability is
Lithium
Body dysmorphic disorder is often comorbid with
Social phobia
Best treatment for paranoid personality disorder
Individual therapy
In what stage do they understand no matter shape the clay is in, it’s still clay
Concrete operations
What’s an example of a 2nd gen that’s FDA approved for bipolar depression
Quetiapine
What’s an antidepressant that doesn’t have a lot of drug-drug interactions for older adults
Sertraline
What are 3 examples of meds you should not give with bupropion because they lower seizure threshold
Clozapine, theophylline, clomipramine
In illness anxiety disorder, criterion D is
The person has excessive health related behaviors
The problems linked to Freud’s oral stage
Paranoia, schizophrenia, substance abuse
Early onset bipolar is less responsive to
Lithium
Maximum daily dose for divalproex sodium
60mg/kg/day
Acne is a side effect of
Lithium
How many symptoms are required for the diagnosis of panic disorder
4
Nortriptyline and the elderly
Even though it’s a TCA, it’s a first line option for elderly people with melancholic depression
What’s a complementary therapy that can help with OA and RA pain
Acupuncture
Anticonvulsant medications that are pregnancy C
Gabapentin, pregabalin, lamotrigine
What area of the brain does smell
Limbic
Adult patient, myoclonic jerks, rapid progress toward dementia, akinetic mutism
Creutzfeldt-Jakob
Agitated patient has vertical nystagmus, rotary nystagmus, and psychotic behavior. What do you do?
He’s high on PCP, give benzos for agitation.
Carbamazepine causes what electrolyte imbalance
Low sodium
Carbohydrate deficient transferrin
A biomarker for alcohol use
Medicare part A covers
Inpatient hospital stay, SNF, hospice, home health care
Medicare part B covers
Clinical research, ambulance, durable medical equipment, limited prescription drugs, psych treatment
How long does it usually take before DTs happen
2 to 3 days
What kind of inhibitor is ketoconazole
CYP3A4
What is a benefit of Ramelteon
It’s a sleep medication that doesn’t carry abuse potential
Bupropion can increase levels of
Amitriptyline
Carbamazepine induces
Theophylline
Childhood onset fluency disorder means
Stuttering
Ramelteon mechanism
Melatonin 1 and 2 agonist
Separation anxiety is normal between ages
10 to 18 months
The antidote to prevent systemic effects of benzo intoxication is
Flumazenil (not flurazepam)
Which drug has the best evidence for treating drug-induced psychosis in Parkinson’s patients
Clozaril
What is the minimum baseline ANC you need to have before starting Clozaril
1500
What do you give for anticholinergic delirium (anticholinergic overdose)
Physostigmine
What condition has low CoQ10 levels
Parkinsons
The most common comorbidities with Fragile X syndrome are
ADHD and social anxiety disorder
Desvenlafaxine fun facts
It’s weakly protein bound and has an earlier onset of action compared to other antidepressants.
Topiramate and oral contraceptives
Topiramate effects the efficacy, but only at doses of 200mg or more
Varenicline mechanism of action
Partial agonist at alphabeta and full agonist at alpha7
Carbamazepine when breastfeeding?
It’s safe
Inducers: GPS Cell Phone Ring
Griseofulvin Phenytoin Smoking Carbamazepine Phenobarbital Rifampin
Which exam would you give for a patient over 50 with change in mental status, mood, personality, or behavior
MRI
Conversion disorder, illness anxiety disorder, and somatic symptom disorder
Conversion disorder happens and resolves quickly, and they’re not that upset about. Illness anxiety is when they are fine but worry about being sick. Somatic symptom is when they are sick, but they’re way too worried about it.
