Psych-1 Flashcards
SSRI safe for pregnant women
Fluoxetine
SSRI with highest Nausea and Diarrhea
Sertraline
SSRI with fewest drug-drug interactions
Citalopram
SSRI you don’t have to taper
Fluoxetine
SSRI used for OCD
Fluvoxamine
Skinny old depressed lady who can’t sleep.
Mirtazapine A2 agonist will cause weight gain and drowsiness
Treats depression and neuropathic pain
Duloxetine
Norepi and Dopa uptake inhibitor that lowers the seizure threshold
Buproprion
Drug for depression that increases BP.
Venlafaxane (SNRI)
Side effect of mirtazapine
Agranulocytosis
TCA approved for OCD
Clomipramine
Atypical antipsychotic with highest EPS risk and Inc. Prolactin
Risperidone
Atypical Antipsychotic that increases the QTC,
Ziprasadone
Atypical anti-psychotic. weight neutral, Increases akathasia
Ariptrazole “Ants in the Pants”
Atypical Antipsychotic that causes orthostasis and cataracts
Quetiapine (Has Alpha Blocking properties)
What do you treat Benzo withdrawal with ?
Diazepam
What do you treat a specific phobia with ?
Flooding or Exposure/Extinction
What do you treat a social phobia with
Beta blocker / Benzo
Gold Standard to treat OCD ? What is 1st line?
Clomipramine is gold standard, SSRI are first line. + Exposure Response Prevention
What do you treat PTSD with ?
Sertraline or Paroxetine combined with CBT
Sleep Spindles and K Complexes
Stage 2
Sleep walking and night terrors
stage 3
What causes Fragile X
CGG Repetes w/ anticipation. X-Linked. Seizure, MVP, Dialation of the aorta, tremors, ataxia,
Cafe- au - Lait, Seizures, Large Head
Neurofibramatosis
Coarse facies, short stature, cloudy cornea. Autosomal Recessive
Hurlers Syndrome
Smith Magenis ?
Broad, square face, short stature, deletion of chrome 17, self injurious behavior.
Hypotonia, hypogonadism, hyperphagia, skin picking, agression, chrom 15 deletion.
Prader-Willi (Paternal deletion / Prader Willi
Seizures, Strabismus, Sociable Episodic Laughter, Deletion on maternal chrom 15
Angelman.
Chromosome 7 deletion. Elfin appearance, Increased empathy and verbal reasoning
Williams
Person on an antipsychotic developed a grey rash and jaundice.
Chlorpromazine
Person on antipsychotics developes inc.QTc retinopathy
Thioridazine
Resistant schiophrenia
Clozapine.
Bipolar and Pregnant
Clonazapam
Bipolar and developed hepatitis
Valproic Acid.
SSRI with MOST Drug - Drug Interactions
Paroxetine
5HT discontinuation syndrome is common with ?
Sertraline and Fluvoxamine
Depressed patient with hypertension, should not get ?
Venlafaxane
What do you give a patient who is in a hypertensive crisis
IV Phenatolamine.
How do you treat the 2 forms of schizoaffective disorder ?
Atypical Antyipsychotic + Li if manic, and SSRI if depressive.
SSRI for social phobia
Paroxetine.
Rapid Cycling Bipolar
Carbemazepine
OCD, What do you always rule out ?
PANDAS.
What do you give for NMS
Bromocriptine
Peripherazine
This is a high potency antipsychotic.
Withdrawl dyskinesia
When haldol dose is decreased the TD will initially worsen.
Antipsychotic for predominately negative symptoms
Olanzapine
sibling of a schizophrenic has a ____% chance of getting schizo.
10
Baseline Psychosis with episodic suicidal attempts
Schizoaffective disorder.
Description of hallucinations but clear sensiorneum and absence of disorganized thinking. +UDS for cocaine
Malingering. Prob trying to avoid law ect.
Hyponatremia in a psychotic patient, increased urine sodium
Psychogenic polydypsia
Psychotic patient who has been symptom free for over a year. What do you do to her meds ?
Gradual reduction in medication with increased visit frequency.
Delusions of persecution and visual hallucinations.
Amphetamine Intox.
Difference in schizophrenia between males and females?
Males have an earlier peak onset and poor outcome.
How do you treat akathasia ?
B-Block or Lorazepam. All other EPS get benzotropin and Diphenylhydramine are the standard treatments of EPS.
What is a delusion
A disturbance in thought content.
Abreaction
Re-enactment of a painful event for a patient
Error of thinking in MDD
Negative thoughts of self in the future
Error of thinking in Anxiety
Overdetermined sense of psychological or physical danger.
Patient in group therapy realizes he or she is not alone.
Universilazation.
A patient has panic attacks, what will the therapist have the patient do in the office.
Have a panic attack. This will allow the patient to face his or her own fears.
What do you monitor with a patient on lithium
Li (0.6-1.2) TFT, Cr
Preg with Opiod Addiction
Methadone : Inc. QTc
Opiod Antagonist that decreases morbidity
Methadone, if they are having withdrawals early in methadone treatment increase the dose.
Opiod antagonist that will precip withdrawal if given acutely
Naltrexone.
Given for the autonomic signs and symptoms in opiod withdrawal Given for muscle cramps during Opiod withdrawal
Clonidine. NSAID.
Adjustment Disorder
Disproportionate response to a stressor
Somatiform
4 Pain 2GI 1 Sexual 1 Pseudoneurologic all are feined by the patient.
PP Blues, Depression, Psychosis
Blues
Dystonia of back and neck
Retrocollius
Timeline of EPS
Dystonia
Management of TD
BNZ, Banclofen, Vit E.
OCD after an infection
ASO and DNase B titers.
Anorexia labs
Patient has depression 2deg GMC. The GMC resolves and the patient still feels depressed.
Antidepressant
ECT side affects
HA, nausea, muscle soreness. Anterograde and Retrograde amenesia
Dysthymic disorder in an adolescent
Only one year of symptoms, adults require two.
Alcoholism is present in ____% of depressed patients
30-40
Study to confirm depression
PET scan shows decreased glucose utilization in the frontal lobes. REM Sleep latency is Prolonged in MDD.
Contraindications to ECT
Anything that could disrupt the blood brain barrier. Aneurysm, MI, Bleeding disorder. OK in epileptics
What can ECT treat ?
> 75% of patients with MDD,
How does dissociative amnesia resolve ?
Reverts spontaneously
depersonalization disorder
Detachment from a persons own body enough to cause distress.
Patient has seizures on Clozapine, what next ?
Change to phenobarbitol and after stable clozapine can gradually be added.
How long do you wait if a patient is not responding to SSRI’s ?
4 weeks
A patient is on a TCA and they develop anticholinergic side effects but taking correct dose, yet blood levels are really high.
5-10% of people metabolize TCA’s at different rates.
SSRI and they get sexual dysfunction, what do you add?
Cyproheptidate
How does Fluoxetine slow metabolism of other drugs ?
It is not a CYP, it just does this.
Pseudodementia with baseline dementia. How do you help this patient?
Trial of SSRI
How long does it take to reach steady state of Li in the body ? What blood level is used in acute mania ?
5-7 days 1 - 1.5
TD but mouth is moving really fast
Rabbit syndrome
Rich in tyramine
Pepperoni and sausage
Benzo for parasomias
Clonazapam
Most sensitive lab for bulimia
Increased amylase activity
Polysonogram finding in narcolepsey
Increased REM latency
Cognitive Behavioral therapy is effective for which conditions ?
Focuses on the connection between thoughts and behaviors. SAD, Substance Abuse, Anxiety, Depression.
Can marijuana cause substance induced mood disorder
NO, Any other substance can.