Psych Flashcards
3 start methods for suboxone?
Micro, macro, standard
One med you cannot give to pts on OAT (or can’t start oat if they’re on it)
Naltrexone!!! Will put them in crazy withdrawal
Dose of ketamine IM for acute agitation
5 mg per kilogram
Algorithm for management of agitation in the emergency department
Some verbal de-escalation strategies
Oral options for agitation in elderly
Risperidone .25-.5 po tid prn
Quetiapine 12.5-25 mg po tid prn with 6.25-12.5 or 12.5-25 q6h prn
Parenteral medsfor severe agitation in elderly
Haldol 0.5-1 mg IM/SC q1h prn
Loxapine 2.5-5 sc/IM q2h prn max 25 in 24 hrs
What is acute dystonia?
What is the management?
Muscle spasm of neck face back or most common can also get oculogyric crisis.
Treatment is Bentrup pain 1 to 2 mg IV or IM or diphenhydramine 25 to 50 mg IV
Patient population most likely to get acute dystonia?
Young males who have never taken antipsychotics
What is akathisia?
Sensation of motor restlessness, (creepy crawlies), difficult to manage, can trial be benztropine 1 mg PO BID
Symptoms of neuroleptic, malignant syndrome?
Rigidity, fever, autonomic, instability (tachycardia, diaphoresis, and hyper or hypotension), altered mental status
FARM pneumonic
Management of neuroleptic, malignant syndrome
Supportive. Not anticholinergics!
Use cooling blankets and can try dantrolene need to discontinue antipsychotic and probably admit to ICU.
Screening questionnaire for eating disorders
SCOFF, score of two or more is positive
Lab abnormalities in re-feeding syndrome
Hypokalemia, hypophosphatemia, hypomagnesaemia
Why is refeeding syndrome dangerous
There’s red distribution of electrolytes from the extracellular to the intercellular space triggered by insulin release. This leads to arrhythmia, heart failure, pericardial, effusion, and cardiac arrest.
ECG findings of severe eating disorders
Bradycardia, prolonged QT.
Also causes orthostasis and hypotension
Eating disorder, criteria for hospital admission
Timeline of alcohol withdrawal seizures
90% occur within 48 hours can occur up to 60 hours after stopping or reducing
Continuum of alcohol withdrawal
Treatment of delirium tremens
One off treatment of alcohol withdrawal that is uncomplicated i.e. no seizures or delirium
