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Paige: Psych > Pharm Blessings last time ever AYO > Flashcards

Pharm Blessings last time ever AYO Flashcards

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1
Q

this is about to be a blast

A

PSYCH!
^^^^see what I did there^^^^
anyway, no, this is not about to be fun

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2
Q

are hallucinations a positive or negative psychosis symptom

A

positive

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3
Q

how do you treat positive psychosis symptoms?

A 
WELL, historically, they use FGA if someone has only positive symptoms. BUT in class they said:
SGA like risperidone [risperdal] or quetiapine [seroquel]
So make of that what you will.
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4
Q

drugs that increase _______ cause sexual dysfunction in the 2nd gen antipsychotics

A

prolactin

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5
Q

does quetiapine [seroquel] increase prolactin levels?

A

no

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6
Q

the majority of the time, do we use FGA (first gen antipsych) or SGA (second gen antipsych)?

A

SGA

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7
Q

what are the 2 methods of giving risperidone [risperdal]?

A

PO or IM

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8
Q

disorganized speech, flat affect, and decreased short-term memory… positive or negative sx?

A

negative

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9
Q

what are the most prominent side effects of FGA

A

serious EPS*
sedation*
and more but who cares about those, i know i don’t

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10
Q

when on FGAs, you need to do an AIMS score every ___ months

A

6

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11
Q

What are the most prominent s/e of SGA?

A

metabolic*

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12
Q

what are the s/e of a dopamine antagonist?

A

uninhibited prolactin release

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13
Q

you have a patient with PD and agitation. what do you rx?

A

SGA like quetiapine [seroquel]

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14
Q

You have a pt with unipolar depression and hypomania. they want to know if Lurasidone [Latuda] or Quetiapine [Seroquel] is better for their mixed depressive symptoms?

A

Quetiapine [Seroquel]

less TD, less neuromusc sx, cheaper!

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15
Q

If on Clozapine [Clozaril], you need weekly blood tests to check for _______

A

agranulocytosis

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16
Q 
T2DM
hyperlipidemia
obesity
angina
tobacco use
are all relative c/i to what type of drug
A

SGA

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17
Q

elderly people on SSRIs have increased risk of what?

A

QTc prolongation

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18
Q

which SSRI drug has the biggest increased risk for QTc prolongation?

A

Citalopram [Celexa]

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19
Q

citalopram [celexa] + ziprasidone [geodon] causes what label of interaction?

A

X

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20
Q

how many psychotherapists does it take to change a light bulb?

A

Just one

as long as the lightbulb wants to change

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21
Q

pt is on lithium and halperidol [haldol] and has a new onset eye twitch. what’s going on?

A

med s/e
decrease Li
change to SGA like risperidone [risperdal]
do AIMS score

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22
Q

what is the average dose of halperidol [haldol]

A

4mg

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23
Q

TD is almost never seen before ______

and is usually seen after _________

A

not seen before 6 months

usually after 2-3y

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24
Q

after you fix TD, how long does it take to go away?

A

sometimes years

EEEEEEEEK

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25
Q

do FGA or SGA have an increased risk of CVD and hepatic/renal impairment?

A

SGA

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26
Q

are FGA or SGA more expensive?

A

SGA

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27
Q

just in general, _____% of people will fill their prescription by 2 weeks, and ____ will refill a second time

A

50

1/3

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28
Q

if you are on an SSRI and start Tramadol, you could get _____________

A

serotonin syndrome

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29
Q

WHEN I SAY increased heart rate, increased temp, agitation, hyperreflexes, confusion, and myoclonus YOU SAY _________

A

serotonin syndrome

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30
Q

how long does it take for fluoxetine [prozac] to clear from the system

A

6-8 weeks

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31
Q

What can tramadol cause in the elderly

A

seizures

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32
Q

THROWBACK BUT ALSO KIND OF RELATED:

what is the drug you rx for dementia in parkinson’s or alzheimer’s?

A

aricept

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33
Q

patient with dementia has increasing agitation.

what do you do?

A

“find the root cause. are they in pain? are they hungry?” - Maria Egger

“give ‘em the haldol” - Tom White

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34
Q

what drug is given for agitation, but can actually increase agitation in some?
Why is this?

A

benzos

work on PFC and decrease self control

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35
Q

what is a long-term treatment for aggression in dementia?

A

SGA

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36
Q

what is the short-term treatment for panic attacks?

A

benzos

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37
Q

what is the longest amount of time you should put a person on benzos for?

A

4 weeks — addicting d/t dopamine surge!!

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38
Q

what are two long-term therapy options for panic disorder?

A

SSRIs

SNRIs

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39
Q

what is the MC s/e of SSRIs in men (also happens in women)?

A

sexual dysfunction

40
Q

if a pt is on an ssri and gets sexual dysfunction then what should you rx instead?

A

long-term hooker services

and if that doesn’t work then Buproprion [Wellbutrin]

41
Q

what is the DOC for post-partum depression

A

sertraline [zoloft] and CBT

42
Q

ssri’s are passed in the breast milk. how long should you wait after taking them before breast feeding?

A

7-9 hours

43
Q

which ssri has the lowest concentration in breast milk?

A

sertraline [zoloft]

44
Q

what is the definition of ADHD

A

brb gonna make a smoothie

45
Q

no but really what’s the definition of ADHD

A

it occurs over 2 settings
you are hyperactive/impulsive AND can’t pay attention
you can’t make a serious deck of flash cards to save your life

46
Q

so likkkeeeee you’ve got a pt with GAD and PTSD and we talked about TWO.. that’s right.. TWO drugs that can treat this. what are they

A

sertraline [zoloft]
paroxetine [paxil]
so SSRIs I’m guessingq

47
Q

what happens if you combine a non-benzo + a benzo?

not like that’s broad or anything

A

combined hypnotic sedation effect

48
Q

I know you know this by now. what is the DOC for anxiety and depression?

A

SSRI

49
Q

what can you give off-label for insomnia?

A

trazadone

50
Q

what is the + response rate of SSRIs

A

60-80%

51
Q

how long does it take to get a full effect from SSRIs?

A

6-8 weeks

52
Q

Which SSRI drug is the only one that self-titrates itself down in one week?

A

fluoxetine [prozac]

53
Q

a pt started fluoxetine [prozac] and is now agitated and anxious with insomnia. help him please

A

it’s a drug s/e because this drug is stimulating

start on a less stimulating SSRI

54
Q

so, which SSRIs are less stimulating/are sedative?

A

paroxetine [paxil]
citalopram [celexa]
eschitalopram [lexapro]

55
Q

what is a c/i to buproprion [wellbutrin]?

A

seizure disorder

it lowers the seizure threshold

56
Q

this drug that’s called Belsomra [suvorexant] (never heard of it) increases the s/e of what?

A

suicidal thoughts

57
Q

What 2 drugs treat OCD?

A

Fluoxetine [prozac]

Venlafaxine [effexor]

58
Q 
if there is a test question that looks like this:
what treats OCD?
a) irrelevant answer
b) something totally unrelated
c) fluoxetine [prozac]
d) venlafaxine [effexor]
then what should you answer on the exam
A

fluoxetine [prozac]

because SSRIs are bae

59
Q

what happens if a person is bipolar and you put them on an ssri for treatment, thinking that they have major depression?

A

congrats you just killed a patient

totally just kidding, it just unmasks their symptoms of mania

so in this case SSRIs are not bae

60
Q

what seizure drug is also a mood stabilizer

A

valproate

61
Q

a pt with MDD has had no effect with ssri, snri, tca, tetracyclics, or atypical antidepressants. what option is left?

A

MAOI

62
Q

what can’t you eat with MAOIs

A

tyramine (bread, beer, sauerkraut)

63
Q

which SSRI is on the $4 list or $5 list or what ever dollar amount it is list?

A

paroxetine [paxil]

64
Q

how long do you have to down-titrate paroxetine [paxil]? what happens if you dont?

A

over 3-4 weeks

if you don’t, then insomnia, dizziness, paresthesias

65
Q

SSRIs are Cat C in pregnancy except _______ which is Cat D

A

paroxetine [paxil]

66
Q

what do SSRIs increase in the elderly?

A

flexibility
armpit hair
QTc prolongation
(spoiler alert: only one of those is correct)
(spoiler alert 2: i think this was already a flash card)

67
Q

pt has PTSD with hallucinations

what do you put him on

A

SGA

68
Q

pt has PTSD with hallucinations but he has DM so can’t go on an SGA. what do you put him on?

A

lol idk
beyond my scope
punt to psychiatry

69
Q

what is a dehydrogenase inhibitor used in alcohol abuse?

yes I know that’s the politically incorrect way to say it but I already typed it so I can’t delete it now sorryyyyyy

A

disulfram [antabuse]

which makes them puke if they have alcohol

70
Q

when would you use oxazepam [serax] in alcohol USE DISORDER

i said it correctly that time

A

if they had liver cirrhosis or severe hepatitis

71
Q

why can you use oxazepam [serax] with liver damage?

A

because it produces no additional active metabolites

72
Q

you only treat ADHD with drugs if the child is over _____

A

overly obnoxious

or over 6y

73
Q

what is the DOC for ADHD

A

meth concerts

i mean METH-ylphenidate [CONCERT-a]

74
Q

what 2 drugs can you rx if the ADHD patient fails meth concert treatment?

A

amphetamine [adderall]

atomoxetine [strattera]

75
Q

what is the 3rd line treatment for ADHD?

A

Clonidine [latapres]

76
Q

which ADHD drug from our table is a stimulant?

what is the treatment response when put on stimulants?

A

the meth concerts obviously because that sounds super stimulating
70-90% response

77
Q

what should you do for your pt who wants to quit cocaine?

A

no rx - just detox
can give benzos to help with withdrawal symptoms
reassure that they won’t die from cocaine withdrawals

78
Q

what should you do for your pt who has anorexia nervosa?

A

supportive tx

screen for depression and treat for that

79
Q

can you mix 2 opioids

A

lol no dummy don’t do that

80
Q

what drug can you give for both chronic pain + depression?

A

duloxetine [cymbalta]

“weed” will also be accepted as an answer

81
Q

what’s the big deal with why we probably can’t prescribe methadone as a form of pain control as PAs?

A

well you see methadone has a 1/2 life of 5 days so it’s very easy for a patient to overdose without achieving pain control

also they have trust issues with us… with good reason because we all use sarcastic flash cards to learn pharmacology and then are like, what the fuck did we just learn anyway

82
Q

what kind of side effects do TCAs have?

A

severe anticholinergic side effects

83
Q

what will a psychiatrist prescribe for bipolar disorder?

A

lithium

84
Q

what will you probably prescribe for bipolar disorder while waiting for the patient to get in for a psych eval?

A

SGA like quetiapine [seroquel]

85
Q

patient is on lithium for bipolar d/o and has become sleepy with a fine tremor and has polyuria, polydipsia, and weight gain. WHAT ON EARTH

A

Diabetes insipidus is a s/e of lithium

switch to valproate

86
Q

a patient has MDD. they started fluoxetine [prozac] and got anxious, just like the other patient you had earlier today.
how do you differentiate a med s/e from mania?

A

just ask them how many ovens they have

mania = buying lots of ovens
great education being provided at UNE

87
Q

how many times per year is rapid cycling

A

4

88
Q

what drug can you give for smoking cessation + depression?

A

buproprion [wellbutrin]

89
Q

what is the tetracyclic antidepressant that causes sedation?

A

mirtazapine [remeron]

90
Q

there is an opioid overdose

what drug is its anti-drug?

A

naloxone [narcan] IV

91
Q

what opioid use drugs might you use for long-term therapy?

A

suboxone and methadone

92
Q

drugs that bind to and activate a given receptor, but have only partial efficacy at the receptor relative to a full agonist

A

partial agonist drugs

93
Q

omg that drug that i’ve never heard of is back
we’re going to learn about it
what is the MOA of suvorexant [belsomra]?

A

works on orexin receptors (primarily wake receptors)

94
Q

what are the s/e of suvorexant [belsomra]

A

complete muscle laxity, falls, borderline narcolepsy, suicidal thoughts, unusual dreams
sounds solid

95
Q

all jokes aside, I do take mental health very seriously

A

but these are my pharm blessings and in pharm blessings i do what i want

96
Q

well my little psychology and psychiatry nerds, I hope these help and these are my LAST. FUCKING. PHARM. BLESSINGS. EVER.

A

BLESS YOU A TON BLESSINGTON
I’d like to thank all my fans, but also Blessington, Jesus, cinnamon toast crunch cereal, my ADD, and lastly my mother for making me weird

Paige: Psych (1 decks)

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