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BCACP > Psych > Flashcards

Psych Flashcards

1
Q

What is considered first-line treatment for most anxiety disorders?

A

CBT

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2
Q

What class of medications is considered first-line for all anxiety disorders and PTSD?

A

SSRIs

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3
Q

What is the maximum citalopram dose for patients > 60 years old?

A

20 mg/day

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4
Q

Which SNRI has more data to support its use in anxiety disorders?

A

Venlafaxine

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5
Q

What type of anxiety disorder is buspirone approved for?

A

GAD

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6
Q

When may beta blockers be appropriate for anxiety disorders?

A

Performance-related social anxiety disorders (such as public speaking)

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7
Q

What is the role of prazosin in PTSD management?

A

PTSD-associated nightmares

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8
Q

What type of anxiety disorder are BZDs more effective?

A

GAD

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9
Q

What is the recommended duration of BZD treatment for anxiety?

A

Short-term (2-3 weeks while initiating and titrating a first-line treatment)

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10
Q

What anxiety disorder should BZDs be avoided with?

A

PTSD (can interfere with effectiveness of trauma-based psychotherapy)

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11
Q

Which BZDs are preferred in the elderly?

A

-Lorazepam
-Oxazepam

*both lack an active metabolite

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12
Q

When is a taper necessary with BZD therapy?

A

In those receiving BZDs regularly for > 2-4 weeks

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13
Q

Which insomnia medications help with sleep latency?

A

-Ramelteon
-Trazodone
-Zaleplon
-Zolpidem IR

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14
Q

What insomnia medications help with sleep maintenance?

A

-Doxepin

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15
Q

What insomnia medications help with both sleep latency and maintenance?

A

-Temazepam
-Daridorexant
-Eszopiclone
-Lemborexant
-Suvorexant
-Zolpidem CR

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16
Q

What are side effects of Z-hypnotics?

A

-Amnesia
-Dizziness
-Increase risk of falls and fractures

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17
Q

What is a benefit of ramelteon over Z-hypnotics?

A

Not associated with dependence or tolerance and can be used for chronic insomnia

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18
Q

What is a counseling point for orexin receptor antagonists?

A

There must be at least 7 hours between taking the dose and having to wake up

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19
Q

What class of insomnia medications should be avoided in those with sleep apnea?

A

BZDs (decrease upper airway tone and ventilatory response to hypoxia)

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20
Q

What is the general approach to treating depression?

A

-Psychotherapy +/- medication (SSRI/SNRI, bupropion, mirtazapine, vortioxetine, vilazodone)

-Change medication

-Third medication trial w/ different MOA or augmentation (bupropion, mirtazapine, lithium, selected SGAs, lithyronine, methylphenidate, TMS)
**if not had > 50% reduction in symptoms, change over augment

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21
Q

What are common side effects of SSRIs?

A

-Irritability
-Sedation
-Insomnia
-Sexual dysfunction
-Headache
-Sweating
-GI effects

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22
Q

How can sexual dysfunction side effects w/ SSRIs be managed?

A

-Lower dose of antidepressant
-Add or change to bupropion or mirtazapine
-Add PDE-5 inhibitor

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23
Q

What enzyme does fluoxetine and paroxetine inhibit?

A

CYP2D6

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24
Q

In which patient population should caution be used with SNRIs?

A

Uncontrolled HTN

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25
Q

What are side effects of TCAs?

A

-Sedation
-Anticholinergic effects
-Weight gain
-Sexual dysfunction

26
Q

What is required when switching from a MAOI to SSRI/SNRI (or vice versa)?

A

Washout period before/after of 2 weeks (5 weeks w/ fluoxetine)

27
Q

What black box warning dose nefazodone carry?

A

Hepatoxicity

28
Q

What are SSRI/SNRI withdrawal symptoms?

A

-Increased anxiety
-Dizziness
-Irritability
-Feeling of mild electric shocks
-Flu-like symptoms
-GI symptoms

29
Q

What are symptoms of serotonin syndrome?

A

-Autonomic instability (labile BP, tachycardia, hyperthermia)
-Mental status changes (agitation, hallucinations)
-Neuromuscular symptoms (hyperreflexia, incoordination)
-GI distress (nausea, vomiting, diarrhea)

30
Q

Which SSRI should be avoided in pregnancy?

A

Paroxetine

31
Q

What should a woman do if she discovers she is pregnant while taking an antidepressant?

A

Continue that antidepressant rather than change

32
Q

What therapies may be used for an acute manic episode in bipolar disorder?

A

-Lithium
-Divalproex
-SGA

33
Q

What therapies may be used for acute bipolar depression?

A

-Quetiapine
-Lurasidone
-Olanazapine/fluoxetine
-Lumateperone
-Cariprazine

34
Q

What therapies may be used for an acute mixed episode in bipolar disorder?

A

Valproate + an antipsychotic

35
Q

What is the therapeutic serum concentration of lithium for bipolar disorder?

A

0.6-1.2 mEq/L

36
Q

What are side effects of lithium therapy?

A

-GI upset
-Tremor
-Diabetes insipidus
-Weight gain
-Acne
-Alopecia
-Leukocytosis
-Hypothyroidism
-Renal toxicity

37
Q

Which medications increase lithium concentrations?

A

-NSAIDs
-Thiazide diuretics
-ACE-Is/ARBs

38
Q

What is the preferred mood stabilizer for mixed episodes and rapid cyclers?

A

Divalproex/valproic acid

39
Q

What are side effects of divalproex/valproic acid?

A

-GI upset
-Weight gain
-Thrombocytopenia
-Hyperammonemia
-Alopecia
-Tremor
-Hepatotoxicity**
-Pancreatitis**
-PCOS
-Amenorrhea
-Leukopenia
-Osteoporosis
-Sedation

40
Q

Which antipsychotics are approved for maintenance of mania in bipolar disorder?

A

-Asenapine
-Quetiapine
-Risperidone
-Ziprasidone

41
Q

Which antipsychotics are approved for bipolar depression?

A

-Cariprazine
-Lurasidone
-Olanzapine/fluoxetine
-Quetiapine

42
Q

What is the recommended treatment for mixed symptoms of bipolar disorder?

A

-SGA (aripiprazole, asenapine, cariprazine, olanzapine, quetiapine)
-VPA

43
Q

What are the 5 main features of schizophrenia?

A

-Hallucinations
-Delusions
-Disorganized speech
-Disorganized or abnormal motor behavior
-Negative symptoms

44
Q

What symptoms of schizophrenia do typical antipsychotics treat?

A

Positive symptoms

45
Q

For which atypical antipsychotics is there a long-acting injectable formulation available?

A

-Aripiprazole
-Olanzapine
-Paliperidone
-Risperidone

46
Q

What are extrapyramidal symptoms associated with antipsychotics?

A

-Acute dystonic reactions (can treat w/ benztropine)
-Psuedoparkinsonism
-Akathisia (inner restlessness - can treat w/ propranolol)
-Tardive dyskinesia

47
Q

Which antipsychotics is hyperprolactinemia more common with?

A

-Haloperidol
-Risperidone
-Paliperidone

48
Q

Which antipsychotics is sedation more common with?

A

-Chlorpromazine
-Olanzapine
-Clozapine
-Quetiapine

49
Q

What is the composition of Metadate CD?

A

30% IR beads + 70% ER beads

50
Q

What is the first-line treatment recommendation for ADHD in patients 6-18 years old?

A

Methylphenidate
OR
Amphetamine products

51
Q

What are second-line treatment options for ADHD in patients 6-18 years old?

A

-Atomoxetine
-Guanfacine ER
-Clonidine ER

52
Q

What is the first-line treatment recommendation for adults with ADHD?

A

Methylphenidate
OR
Lisdexamfetamine

53
Q

Which ADHD medication(s) is not used as monotherapy?

A

Clonidine and guanfacine (target impulsivity and hyperactivity)

54
Q

What are symptoms of nicotine withdrawal?

A

-Anxiety
-Craving
-Difficulty concentrating
-Increased appetite

55
Q

Which BZDs are used for the treatment of alcohol withdrawal?

A

-Chlordiazepoxide
-Diazepam
-Lorazepam**
-Oxazepam**

**preferred in liver dysfunction

56
Q

What are first-line treatment options for AUD?

A

-Naltrexone
-Acamprosate

57
Q

What are second-line treatment options for AUD?

A

-Topiramate
-Gabapentin
-Disulfiram

58
Q

What are symptoms of opioid withdrawal?

A

-Nausea, vomiting, diarrhea
-Anxiety
-Headache
-Muscle pain
-Fever
-Elevated BP/HR

59
Q

What is the only FDA-approved treatment for opioid dependence for pregnant individuals?

A

Methadone

60
Q
A

BCACP (20 decks)

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