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PCP > Psych > Flashcards

Psych Flashcards

1
Q

Monitoring of antipsychotics

A
  1. BMI (every visit > q3 months)
  2. FBG (q3 months > annual)
  3. Lipid panel (q3 months > q6 months)
  4. Prolactin (baseline)
  5. BP (q3 months > annual)
  6. EPSE (q3 months > annual)
  7. WBC/ANC (weekly x 18 months > monthly)
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2
Q

TCA drug interactions

A
  • Tertiary amines (amitriptyline, imipramine): 2D6, 3A4 metabolism
  • Secondary amines (nortriptyline, desipramine): 2D6 metabolism
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3
Q

Special SSRI administration

A
  • Fluoxetine (in AM)
  • Sertraline (with food)
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4
Q

Additional side effects of SNRIs

A

Diaphoresis
Raised BP (venlafaxine)
Reduced appetite, urinary hesitancy (duloxetine)

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5
Q

Benefit of mixed serotonergic agents

A

Mirtazapine (less GI, less sexual dysfunction)
Vortioxetine (lMess GI)

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6
Q

Management of dystonia and pseudo-parkinsonism

A

Anticholinergics i.e. Benzhexol

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7
Q

Management of akathisia

A

PRN Clonazepam
Propranolol 20 mg TDS

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8
Q

Management of tardive dyskinesia

A

Worsened with anticholinergics
PRN Clonazepam
Valbenazine

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9
Q

Management of hyperprolactinemia

A

Dopamine agonists (amantadine, bromocriptine)
Switch to aripiprazole, bexpiprazole

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10
Q

Differential QTc prolonging effect of antipsychotics

A
  1. Chlorpromazine
  2. Ziprasidone
  3. Haloperdol
  4. Quetiapine
  5. Risperidone
  6. Olanzapine
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11
Q

Management of neuroleptic malignant syndrome

A

IV Dantrolene

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12
Q

1A2 inhibitors

A

Fluvoxamine
Ciprofloxacin

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13
Q

2C19 inhibitors

A

Fluvoxamine
Omeprazole
Fluoxetine, voriconazole

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14
Q

2D6 inhibitors

A

Fluoxetine
Paroxetine
Bupropion

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15
Q

Adequate trial for antipsychotics

A

2-6 weeks at therapeutic range

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16
Q

Antipsychotics with lower metabolic side effects

A

Aripiprazole
Brexpiprazole
Cariprazine
Lurasidone
Haloperidol

17
Q

Adequate trial for antidepressants

A

4-8 weeks

18
Q

Total treatment duration for antidepressants

A

At least 4-9 months after acute treatment

19
Q

Antidepressant of choice in pregnancy

A

Nortriptyline if late pregnancy

20
Q

Antidepressant of choice in breastfeeding

A

Sertraline
Mirtazapine

21
Q

Antidepressant of choice in post-MI

A

Sertraline

PCP (9 decks)

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