Psych Flashcards
What antidepressants should we not use in the elderly?
Prozac due to long half-life
TCAs- anticholinergic side effects
What do we need to be mindful of prior to prescribing an aytpical psychotic such as seroquel or zyprexa?
Side effects of weight gain and HLD
Need a lipid profile, fasting BG, and weight before starting.
Treatment of bipolar depression?
Lithium
With this the patient may present with nightmares, flashbacks, hyper vigilance, exaggerated startle response, and insomnia?
PTSD
Treatment of PTSD?
SSRIs
This is depression routinely at the same time every year.
Seasonal affective disorder
What does seasonal affective disorder primarily effect?
Patient’s circadian rythm
Treatment of seasonal affective disorder?
More sunlight
What is the CYP2C19?
This enzyme is found in the asian population which increases metabolism of pain medication.
What is lexapro good for?
OCD, has quick onset
What is Paxil good for?
OCD, pre-menstrual disorders, menopausal symptoms
What do we worry about with Paxil?
Weight gain and sedation
What is Prozac good for?
Bulimia because it is weight neutral- patient may feel jittery
Who do we not give Zoloft to?
Those under the age of 24 due to increased risk of suicidal ideation.
What SSRI has the longest half-life?
Prozac
What SSRI has the shortest half-life?
Celexa
What SNRI can also be used for neuropathic pain and post-herpetic neuralgia?
Cymbalta
SNRIs are contraindicated in those with?
HTN
With TCAs what are you more likely to see as a side effect?
Weight gain
With TCS, what do we need to assess before prescribing and why?
Cardiac history- slows cardiac conduction
In a patient over 40, must get an EKG
Rasagline and selegline are examples of?
MAOIs
What are MAOIs used for?
For refractory and atypical depression
What foods should you avoid if taking an MAOI?
Must avoid foods high in tyramine such as aged cheese, fermented sausages, cured meat, and yogurt. - can cause HTN crisis
With buspar what should you not take with it?
MAOI
grapefruit juice
Lithium T.I:
(0.6-1.2)
Can we give lithium during pregnancy?
No
Long-term side effects of lithium?
goiter, hyperthyroidism, and harmful effects on the kidneys
What does HARM stand for regarding serotonin syndrome?
H- High fever
A: autonomic rigidity
R: hyper-reflexia
M: myoclonus
