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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
Q

CNS side effects of lithium

A

Fine tremor (coarse with toxicity), fatigue, cloudiness,headaches, nystagmus

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26
Q

Dermatological effects of lithium

A

Maculopapular rash, pruritis, acne

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27
Q

G/I side effects of lithium

A

N/V/D, cramps, anorexia

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28
Q

Renal side effects of lithium

A

DI, Polyuria, polydipsia, edema, microscopic tubular changes

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29
Q

Cardiac side effects of lithium

A

T wave inversion, dysrhythmia

30
Q

Hematologic side effects of lithium

A

Leukocytosis

31
Q

Kidney disease or drugs that reduce renal clearance (nsaids, thiazide, ACEIs) may _____serum concentrations of drugs excreted by kidneys (lithium)

A

Increase

32
Q

Signs of lithium toxicity

A

Severe N/V/D, confusion, seizures, drowsiness, blurred vision, slurring, muscle weakness, palpitations, coarse hand tremors, unsteadiness (ataxia)

33
Q

Treatment for lithium toxicity (1.5 or higher)

A

D/C lithium and check serum lithium levels

34
Q

_____kalemia and _____natremia can increase lithium levels

A

Hyper and hypo

35
Q

Treatment for hypertensive crisis with MAOIs (isocarboxazid, selegiline, tranylccypromine)

A

D/C MAOI
administer phentolamine
Stabilize fever

36
Q

Signs and symptoms of hypertensive crisis

A

BP greater than 180/120
Sudden explosive headache
Flushing, palpitations, pupil dilation
Diaphoresis
Fever

37
Q

Use of MAOIs with these drugs can cause hypertensive crisis and death

A

Meperidine
Stimulants
Decongestants
TCA
SGA
St. John’s wort
Asthma meds
L-tryptophan

38
Q

What happens when MAOI is inhibited

A

Tyramine exerts a strong vasopressor effect—> stimulates release of catecholamines, epinephrine, and norepinephrine—> increases BP/HR

39
Q

T or F: hypertensive crisis can cause death

A

True

40
Q

Teratogenic risks of benzos

A

Floppy baby syndrome, cleft palate

41
Q

Teratogenic effects of carbamazepine

A

Neural tube defect

42
Q

Teratogenic risks of lithium

A

Epstein anomaly (congenital heart defect)

43
Q

Teratogenic risks of depakote

A

Neural tube defects, SPINA BIFIDA

44
Q

Psych medications that are safer in pregnancy (3)

A

Lamictal, buspar, Zoloft

45
Q

Lamictal side effects

A

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
Q

Divalproex (depakote) side effects

A

BLACK BOX WARNING: hepatotoxicity and pancreatitis

47
Q

Suggested labs with depakote

A

CBC
LFT
12 hour serum trough after 1 week

48
Q

Side effects of tegretol

A

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
Q

Suggested labs with tegretol

A

CBC
LFT
12 hour serum trough after 1 week

50
Q

_____ ______ supports neural tube development

A

Folic acid- recommended dose during pregnancy is 0.4 - 0.8mg daily

51
Q

Risk for _______ with clozaril and carbamazepine

A

Neutropenia

52
Q

Normal absolute neutrophil count

A

2500-6000

53
Q

Normal white blood cell count

A

4500-11000

54
Q

ANC levels to be checked with clozaril. How often?

A

First 6 months: weekly
2nd 6 months: every 2 weeks
Then monthly

55
Q

ANC blood count <1000 puts a patient at risk for ________

A

Neutropenia (d/c tegretol/clozaril)

56
Q

WBC count between 2000-3000 puts patient at risk for ________

A

Agranulocytosis (d/c tegretol and clozapine)

57
Q

When a patient is taking tegretol or clozapine, monitor for signs of _______

A

Infection

58
Q

Signs of bulimia

A

Normal BMI
Erosion of tooth enamel
Russell’s sign (scaring on hands)
Swollen cheeks (hypertrophy of salivary glands)
Rectal prolapse

59
Q

Pharmacological tx of bulimia

A

Prozac- FDA approved
SSRI/TCA- can reduce frequency of binge and purge

60
Q

S/S or anorexia

A

Low BMI
Amenorrhea
Emaciation (abnormally thin)
Bradycardia
Hypotension
Inverted T wave
Prolonged QT
Hypertrophy of salivary glands
Russel’s sign

61
Q

Non-pharmacological treatments for anorexia

A

Medical/ nutritional stabilization
Weight restoration
Correct electrolyte imbalance
Vitamins
Nutrition counseling
Dental care

62
Q

Types of therapy for eating disorders

A

CBT
Family therapy
Behavioral therapy
Group therapy

63
Q

Underweight BMI

A

<18.5

64
Q

Normal BMI

A

18.5-24.9

65
Q

Overweight BMI

A

25-29.9

66
Q

Obese BMI

A

> 30

67
Q

Largest part of brain, divided into right and left hemisphere

A

Cerebrum

68
Q

Large bundle of white matter where sensorimotor information is exchanged between the right and left hemispheres of the cerebrum

A

Corpus callosum

69
Q

Frontal Lobe functions

A

Executive: working memory, reasoning, planning, prioritizing, sequencing, insight, flexibility, judgement, impulse control behavioral cueing, intelligence, abstraction
Language
Personality

70
Q

What is Broca’s area

A

Located in frontal lobe, responsible for expressive speech.

71
Q

Problems in the frontal lobe can lead to

A

Personality changes, emotional changes, and intellectual changes

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