psych Flashcards
SSRI of choice in children and adolescents
fluoxetine
Alcohol withdrawal results from —what chemical imbalance..?
decreased inhibitory GABA and increased NMDA glutamate transmission
man with schizophrenia taking chlorpromazine develops an oculogyric crisis.
what s/e is this?
acute dystonia
sustained muscle contraction (e.g. torticollis, oculogyric crisis)
symptoms may indicate mania rather than hypomania?
Delusions of grandeur
section 135
allow them to remove a person from their property if they suspect they need a mental health assessment or treatment
Benzodiazepines MOA
enhance the effect of GABA, the main inhibitory neurotransmitter
patients with schizophrenia who have not responded adequately to at least 2 antipsychotics
WHAR drug to go for?
clozapine
electolyte inbalance for Sertaline ssri
SSRIs are associated with hyponatraemia
movement adverse effect of lithium?
fine tremor
patient doesn’t want to take her schizophrenia meds, she does have capacity
what happens with her tx?
Rosie can be treated against her will under section 3, even if she has capacity
Atypical antipsychotics commonly cause
weight gain
hypochondrial vs somatisation vs conversion?
Conversion disorder - typically involves loss of motor or sensory function. May be caused by stress
Imipramine for depression
s/e?
useful clinical tool to differentiate organic from non-organic leg paresis
Hoover’s sign
SSRI discontinuation syndrome
Dizziness, electric shock sensations and anxiety are symptoms of SSRI discontinuation syndrome
paroxetine
SSRI of choice post myocardial infarction
sertraline
person whose death occurs whilst under the mental health act,
mx?
Any person whose death occurs whilst under the mental health act, regardless of cause, must be reported to the coroner
most often used first line for rapid tranquillization in acutely disturbed behaviour
Oral lorazepam
antipsychotics in the elderly - increased risk
of stroke and VTE
Tangentiality refers to …..
Tangentiality refers to wandering from a topic without returning to it
what do you have to cover when prescribing a SSRI?
SSRI + NSAID = GI bleeding risk - give a PPI
SECTION ACT: Allows the police to break into a property if someone appears to be mentally ill
section 135
section Allows admission for 28 days
section 2
Antipsychotics may cause severe restlessness
name the condition?
akathisia
good response to antidepressant therapy they should continue on treatment for at least….
6 months
section: Allows admission for treatment for up to 6 months
section 3
Allows police to take someone who appears to be mentally ill from a public place to the Emergency Department
136
section act? 72 hour assessment order for a patient who is not in hospital
section 4
Under which section of the Mental Health Act (1983) could a GP detain a patient for emergency psychiatric assessment?
GPs may use Section 4 of the Mental Health Act (alongside an AMHP or NR) in order to transfer a patient as an emergency for psychiatric assessment
classic somatic symptom of depression
Early morning waking is a classic somatic symptom of depression and often develops earlier than general insomnia.
Acute dystonia secondary to antipsychotics is usually managed with
procyclidine
first-line drug for generalised anxiety disorder
Sertraline
which anti depressant….?…should be avoided in patients co-prescribed warfarin
citalopram
SSRI
ECT is indicated in
life-threatening major depressive disorder, where catatonia in present
side note: example of catatonia : She did not co-operate with the assessment, seeming to ignore the team.
