psych Flashcards
drugs
Lithium Toxic range
Blood level >1.5
Which mood stabilizer reduce the risk of suicide?
Lithium
What are the side effects of lithium?
1) nephrogenic diabetes insipidus
2)hyperparathyroidism
3)hypothyroidism
4) tremors
5) Hypercalcemia
6) Hypermagnesium
7) Interstitial nephritis
8) Ebstein anomaly (congenital heart defect of tricuspid valve)
What medications are known to increase the levels of lithium?
ACEi/ARB, diuretics, NSAIDs
What are the side effects of Valproate?
Pancreatitis
Liver toxicity
Increase lamotrigine levels
What is the side effect of lamotrigine?
Cause SJS/TEN
What is a side-effect of carbamazepine?
Aplastic anemia, agranulocytosis (increase bleeding, bruising, mouth sores)
SSRI’s can be used off brand to treat?
Premature ejaculation
Only FDA approved antidepressant to treat Bulimia?
Fluoxetine (low risk for weight gain)
Which SSRI has more sexual dysfunction SE?
Paroxtine
The only antidepressant used to treat menopause vasomotor sxs?
Paroxetine
Side effects of paroxetine?
1) More sexual dysfunction
2) anti-histamine activity
3) More anticholinergic activity (dry mouth, weight gain, dry eyes)
Which SSRI should be avoid in patients with QT prolongation?
Citalopram
If patient is fearful of sexual dysfunction. Which anti-depressant can be used?
Bupropion, its also good to smoking cessation
What is the most serious side effect of buproion?
lowers the seizure threshold (increases the risk of seizure) and increases the risk of suicidal ideation
especially in patients with eating disorders
Which SNRI is best used to treat neuropathic pain and fibromyalgia?
Duloxetine
Venlafaxine should be avoided in patients with ?
HTN. can increase BP
Tricyclic antidepressants drugs names
Amitriptyline, nortriptyline
Clomipramine, Imipramine, Doxepin
Which TCA drug is FDA approived for obsessive compulsive disorder
Clomipramine
Which TCA drug is used to treat nocturnal enuresis in children if desmopressin fails?
Imipramine
TCA are known to cause what MAJOR sided effect
Anticholinergic symptoms
1) QT prolongation
2) Seizures-> lowers seizure threshold
3) Coma (AMS)
What is the 1st line treatment for TCA overdose
IV SODIYM BICARBINATE
Which TCA drug is good for treating neuropathic pain
Amitriptyline
What are MAO inhibitor drugs?
Tranylcypromine, phenelzine, selegiline, Isocarboxazid
What is a serious adverse effect of MAO inhibitors?
Hypertensive Crisis: after eating foods high in tyramine (aged cheese, smoked, pickled or cured meat, red wine. MAO inhibitor prevent the break down of tyramine.
What is the treatment of MAO inhibitor tyramine induce hypertensive crisis?
Phentolamine
What is a side effect of trazadone?
Priapism
Presentation of serotonin syndrome/toxicity
initiation or increase dose of a medication that increase serotonin
Altered mental status-> anxiety, agitation
Autonomic instability: hyperthermia, HTN, tachycardia
Neuromuscular hyperactivity: clonus, increased DTR/hyperreflexia
What is the treatment of serotonin syndrome?
Benzo for agitation + Cyproheptadine (serotonin antagonist)
neuroleptoc malignant syndrome sxs
1) automonic instability: fever,sweating
2)AMS: confusion
3) Muscular (lead pipe) rigidity
treatment of neuroleptic malignant syndrome
dantrolene or bromocriptine
16 year old is brought to the ED due to progressive confusion and agitation for the past several hours. His friends report that the boy started to act bizarre after consuming an unknown substance. The patient reports blurred vision. He also frequently interrupts ED staff for a drin of water. The patient is mucous membrane and skin is dry, his face is warm and flushed. Bladder is distended but the patient is unable to urinate. This patient has overdosed on?
Atropine: an anti-cholinergic
