Psych 1 Flashcards
What are the clinical manifestations of Antipsychotic-induced Hyperprolactinemia?
Prolactin secretion is inhibited by hypothalamic dopamine. Risperidone and other antipsychotics block D2 receptors on lactotrophs, leading to inc. prolactin secretion, resulting in galactorrhea and breast soreness. Prolactin also inhibits GnRH, causing amenorrhea and central hypogonadism.
How to benzodiazepines and barbiturates individually affect the GABA-A receptor?
> BZs allosterically modulate GABA binding to the receptor and inc. frequency of Cl channel opening – Cl influx in neuron causes hyperpolarization, inhibits AP.
Barbs act on another allosteric site and prolong duration of Cl channel opening in response to GABA.
What is the first line treatment for Bulimia nervosa?
SSRI (Fluoxetine) + nutritional rehab and CBT
How do you approach management of a patient w/ signs of drug abuse or misuse?
Validate the patient’s concern.
Engage in Nonjudgmental and collaborative discussion of how patient is using meds, and explore reasons for his escalatory use.
What are the contraindications of Buproprion? Why would it be preferred in some cases?
Buproprion is associated w/ inc. seizure risk at high doses.
CI: seizure d/o and eating d/o (anorexia, bulimia).
It’s preferred by some patients cuz it’s not associated w/ sexual side effects or weight gain.
How do you differentiate b/w Neuroleptic malignant syndrome and Serotonin syndrome?
NMS presents w/ rigidity and bradyreflexia, whereas Serotonin syndrome presents w/ neuromuscular hyperactivity (shivering, clonus, hyperreflexia).
*Both may present w/ hyperthermia, autonomic instability, altered mental status.
What forms of depression are MAO inhibitors best used for?
MAOIs are generally used for treatment-resistant depression or atypical depression due to their adverse effects including HTN crisis and Serotonin syndrome.
