Passmed Flashcards
What SSRI causes increased QT ? What anti-psych causes increased QT?
Citalopram
Haloperidol
What SSRI do you use for post-MI depression?
Sertraline
What antidepressant do you give children and adults first line?
Fluoxetine
What antidepressant can cause congenital malformations?
Paroxetine
What do you never give with SSRIs? Why?
MAOis - increased risk for serotonin syndrome
What is erotomania?
Delusion famous person loves them
How do you manage mania in primary care?
Refer urgently to CMHT
Examples of tarditive kinesia
Blink excessively, pout, chewing
Blood gases for bulimia
Hypochloremic metabolic alkalosis
Hypokalaemia as well
Metabolic side effects of antipsych
Dislipidaemia, glycemic, DM
Manage patients with poor compliance to oral anti-psych
Switch to once a month injections
Manage antidepressants before ECT
Reduce dose but don’t stop
Peak for seizures and delirium after alcohol withdrawal
36 hours
72 hours
How do you diagnose schizophrenia?
2 of: Delusions, hallucinations, disorganized speech, disorganized / catatonic behaviour, negative symptoms 1 has to be one of the first 3 Ongoing for 6+ months Not explained by any other condition
5 subtypes of schiz
- Paranoid (+ symptoms)
- Disorganized (hebenephric)
- Catatonic
- Undifferentiated
- Residual
What are features of paranoid schizophrenia?
Positive symptoms: delusions, hallucinations, thought disorder/disorganized speech
What are the features of disorganized schizophrenia?
Disorganized speech, behaviour, flat/inappropriate affect
What are the features of catatonic schizophrenia?
Immobile, maintained rigid posture, resist movement
Echolalia/praxis
Rocking, nail biting
3 spectrum schiz disorders
- Schizoaffective: schiz + bipolar
- Schizopheniform: shorter duration
- Schizotypal: impacted social/interpersonal skills, magical thinking, bizzare fantasies
Features of alcohol withdrawal by hour
6-12: anxiety, tremor, tachycardia, sweat
36: seizures
72: delirium, coarse tremor, tachycardia, hallucinations, fever
Acute management of alcohol withdrawal
BZD: chlordiazepoxide / diazepam (lorazepam if hepatic failure)
Maintaining alcohol abstinence treat
Disulfram: causes severe reaction if they drink - throw up!!
Acamprosate: reduces craving
Features of opioid misuse
Pinpoint pupils, needle marks, rhinorrhea, watering eyes, yawning
Opioid overdose treat
IV/IM naloxone
Manage opioid dependence with what drugs
- Methadone
2. Buprenorphine
How long do you monitor opioid dependence treatment
4 weeks in hospital or 12 weeks if in community
ECT is useful for
Severe depression
Absolute contraindication to ECT
ICP increased