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Georgette Review > Module 1 And 2 > Flashcards

Module 1 And 2 Flashcards

1
Q

Normal BMI, erosion of enamel, Russel’s sign, swollen cheeks, rectal prolapse are signs of what eating disorder

A

Bulimia

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2
Q

Low bmi, amenorrhea, emaciation, bradycardia, hypotension, inverted t wave, prolonged qt, swollen cheeks, Russell’s sign are symptoms of what eating disorder

A

Anorexia

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3
Q

What enzyme is clozapine metabolized by

A

CYP1A2

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4
Q

Enzyme inducers (tobacco, tegretol) can ____________ the serum level of other drugs.

A

Decrease

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5
Q

Enzyme inducers:
Start smoking = ________ dose
Stop smoking =_________ dose

A

Increase
Decrease

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6
Q

Enzyme inhibitor effect on serum levels of other drugs that are substrates of that enzyme- causing toxic levels.

A

InDucers DECREASE levels of drug
Inhibitors cause HIGH levels

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7
Q

Older adults are more sensitive to psychotropics because:

A

Decreased intracellular water
Decreased protein binding
Decreased muscle mass
Decreased metabolism
Increased body fat

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8
Q

Liver disease affects liver enzyme activity and first-pass metabolism, possibly resulting in:

A

Toxic Plasma drug levels

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9
Q

Mnemonic for inducers:
BS CRAP GPS induces rage

A

Barbiturates
St. John’s wort
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas

Plus cigarette smoking

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10
Q

Mnemonic for inhibitors:
SICK FACES. COM

A

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Acute alcohol
Chloramphenicol
Erythromycin
Sulfonamide
Ciprofloxacin
Omeprazole
Metronidazole

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11
Q

Affects attention and focus, mood regulation, sleep wake cycles, memory formation, fight or flight, reacting to stressful stimulants
Produced in locus coeruleus and medullary reticular formation
Contributes to Anxiety, depression, nightmares

A

Norepinephrine

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12
Q

Produced in raphe nuclei of brain stem
Regulates mood, appetite, sleep, memory, learning.
Disorders: depression, anxiety, ocd

A

Serotonin

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13
Q

Produced in substantia nigra (motor movements), nucleus accumbens( addiction) and ventral tegmental area
Reward and pleasure, motivation, movements.
Imbalances are associate with psychosis and addiction.
Disorders: schizophrenia, bipolar, addiction, and depression

A

Dopamine

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14
Q

Produced in basal nucleus of meynert
Involved with memory, learning, muscle movement
Deficits associated with cognitive decline
Disorders: dementia and Alzheimer’s

A

Acetylcholine

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15
Q

Most abundant inhibitory neurotransmitter.
Calming, reduces neural excitability. A decrease in this neurotransmitter increases anxiety
Disorders: anxiety, epilepsy, addiction

A

GABA

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16
Q

Most abundant excitatory neurotransmitter- increases levels increase anxiety
Cognitive function such as learning, memory, mood disorders
Disorders: schizophrenia, depression, bipolar

A

Glutamate

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17
Q

Which lobe is responsible for executive function (working memory,reasoning, planning, prioritizing, sequencing, insight, flexibility, judgment, impulse control, etc…
Problems lead to personality changes, emotions, and intellectual changes

A

Frontal

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18
Q

Therapeutic lithium level

A

0.6-1.2

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19
Q

When can lithium toxicity occur and what should be done immediately

A

1.5 or higher, d/c med regardless of symptoms

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20
Q

What med is the gold standard treatment for mania

A

Lithium

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21
Q

What is the neuroprotective treatment of choice for bipolar disorder

A

Lithium

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22
Q

What are the baseline labs for lithium treatment

A

TSH, creatinine, pregnancy, ecg (if over 50)

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23
Q

Symptoms of __________can mimic mania

A

HypERthyroid

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24
Q

Endocrine side effects of lithium

A

Hypothyroid, weight gain

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25
CNS side effects of lithium
Fine tremor (coarse with toxicity), fatigue, cloudiness,headaches, nystagmus
26
Dermatological effects of lithium
Maculopapular rash, pruritis, acne
27
G/I side effects of lithium
N/V/D, cramps, anorexia
28
Renal side effects of lithium
DI, Polyuria, polydipsia, edema, microscopic tubular changes
29
Cardiac side effects of lithium
T wave inversion, dysrhythmia
30
Hematologic side effects of lithium
Leukocytosis
31
Kidney disease or drugs that reduce renal clearance (nsaids, thiazide, ACEIs) may _____serum concentrations of drugs excreted by kidneys (lithium)
Increase
32
Signs of lithium toxicity
Severe N/V/D, confusion, seizures, drowsiness, blurred vision, slurring, muscle weakness, palpitations, coarse hand tremors, unsteadiness (ataxia)
33
Treatment for lithium toxicity (1.5 or higher)
D/C lithium and check serum lithium levels
34
_____kalemia and _____natremia can increase lithium levels
Hyper and hypo
35
Treatment for hypertensive crisis with MAOIs (isocarboxazid, selegiline, tranylccypromine)
D/C MAOI administer phentolamine Stabilize fever
36
Signs and symptoms of hypertensive crisis
BP greater than 180/120 Sudden explosive headache Flushing, palpitations, pupil dilation Diaphoresis Fever
37
Use of MAOIs with these drugs can cause hypertensive crisis and death
Meperidine Stimulants Decongestants TCA SGA St. John’s wort Asthma meds L-tryptophan
38
What happens when MAOI is inhibited
Tyramine exerts a strong vasopressor effect—> stimulates release of catecholamines, epinephrine, and norepinephrine—> increases BP/HR
39
T or F: hypertensive crisis can cause death
True
40
Teratogenic risks of benzos
Floppy baby syndrome, cleft palate
41
Teratogenic effects of carbamazepine
Neural tube defect
42
Teratogenic risks of lithium
Epstein anomaly (congenital heart defect)
43
Teratogenic risks of depakote
Neural tube defects, SPINA BIFIDA
44
Psych medications that are safer in pregnancy (3)
Lamictal, buspar, Zoloft
45
Lamictal side effects
BLACK BOX FOR SJS fever Sore throat Facial swelling Tongue swelling Rash (usually goes away in 2-3 weeks) Skin sloughing Prodromal headache, malaise, arthralgia, painful mucous membranes
46
Divalproex (depakote) side effects
BLACK BOX WARNING: hepatotoxicity and pancreatitis
47
Suggested labs with depakote
CBC LFT 12 hour serum trough after 1 week
48
Side effects of tegretol
BLACK BOX WARNING: agranulocytosis, aplastic anemia (pallor, nosebleeds, bleeding gums, fatigue, headache, fever, SOB)- STOP MED SJS- in Asians. Check HLAB-1502 allele before initiation
49
Suggested labs with tegretol
CBC LFT 12 hour serum trough after 1 week
50
_____ ______ supports neural tube development
Folic acid- recommended dose during pregnancy is 0.4 - 0.8mg daily
51
Risk for _______ with clozaril and carbamazepine
Neutropenia
52
Normal absolute neutrophil count
2500-6000
53
Normal white blood cell count
4500-11000
54
ANC levels to be checked with clozaril. How often?
First 6 months: weekly 2nd 6 months: every 2 weeks Then monthly
55
ANC blood count <1000 puts a patient at risk for ________
Neutropenia (d/c tegretol/clozaril)
56
WBC count between 2000-3000 puts patient at risk for ________
Agranulocytosis (d/c tegretol and clozapine)
57
When a patient is taking tegretol or clozapine, monitor for signs of _______
Infection
58
Signs of bulimia
Normal BMI Erosion of tooth enamel Russell’s sign (scaring on hands) Swollen cheeks (hypertrophy of salivary glands) Rectal prolapse
59
Pharmacological tx of bulimia
Prozac- FDA approved SSRI/TCA- can reduce frequency of binge and purge
60
S/S or anorexia
Low BMI Amenorrhea Emaciation (abnormally thin) Bradycardia Hypotension Inverted T wave Prolonged QT Hypertrophy of salivary glands Russel’s sign
61
Non-pharmacological treatments for anorexia
Medical/ nutritional stabilization Weight restoration Correct electrolyte imbalance Vitamins Nutrition counseling Dental care
62
Types of therapy for eating disorders
CBT Family therapy Behavioral therapy Group therapy
63
Underweight BMI
<18.5
64
Normal BMI
18.5-24.9
65
Overweight BMI
25-29.9
66
Obese BMI
>30
67
Largest part of brain, divided into right and left hemisphere
Cerebrum
68
Large bundle of white matter where sensorimotor information is exchanged between the right and left hemispheres of the cerebrum
Corpus callosum
69
Frontal Lobe functions
Executive: working memory, reasoning, planning, prioritizing, sequencing, insight, flexibility, judgement, impulse control behavioral cueing, intelligence, abstraction Language Personality
70
What is Broca’s area
Located in frontal lobe, responsible for expressive speech.
71
Problems in the frontal lobe can lead to
Personality changes, emotional changes, and intellectual changes

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