Psych Flashcards
Treatment for ADHD
Methylphenidate
Treatment for bulimia nervosa
SSRI (fluoxetine)
Ataxia + internuclear opthalmoplegia + confabulation
Wernicke Korsakoff
Seizure + bugs crawling on skin + confusion
Delerium tremens
Intoxication eye clues:
Mydriasis
Miosis
Horizontal/vertical nystagmus
Mydriasis = LSD, amphetamine, cocaine Miosis = opioids Nystagmus = PCP
Heavy feeling in arms and legs + increased sleep + weight gain
Atypical depression
What are the 2 low potency typical antipsychotics?
“CHeating THeives are LOW”
What is their major side effect?
Chlorpromazine and thioridazine
Anticholinergic and sedation
What are the side effects of the high potency typical antipsychotics?
Extrapyramidal (acute dystonia, parkinsonism, akathasia, and tradeoff dyskinesia) and neuroleptic malignant syndrome
What is the major side effect of atypical antipsychotics?
Weight gain
Indications for typical antipsychotics
Psychosis, acute mania, tourette syndrome (fluphenazine, high potency typical)
What are the 4 extrapyramidal side effects and when do they occur?
- Acute dystonia (days) - spasms
- Parkinsonism (1 mo) - bradykinesia
- Akathasia (2 mo) - compulsion to move
- Tardive dyskinesia (mo-yrs) - lip smacking
Delerium + rigidity/myoglobinuria/fever + autonomic instability
Neuroleptic malignant syndrome
What are 2 treatments for neuroleptic malignant syndrome?
Dantrolene and bromocriptine (DA agonist)
Indications for atypical antipsychotics
Psychosis, bipolar/depression, OCD/anxiety/tourette syndrome
What antipsychotic has the strongest association with wright gain?
Olanzapine
Which antipsychotic can cause agranulocytosis? How frequently must CBCs be monitored?
Clozapine
Once per week
What 3 drug categories are used as mood stabilizers in bipolar disorder?
Li, atypical antipsychotics, and anti-seizures
What are 5 side effects for Li?
“LMNOP”
L - Li M - movement (postural tremor) N - nephrogenic DI O - hypOthyroidism, nO heart beat (heart block) P - pregnancy (ebstein anomaly)
Myoclonus/hyperthermia + autonomic instability + flushing/diarrhea + acute mental status changes
Serotonin syndrome
Treatment for serotonin syndrome
Cyproheptadine (5HT2 antagonist)
What 4 non-antidepressant drugs can contribute to Serotonin syndrome?
Amphetamines, sumatriptan, linezolid, and tryptophan
What is the mechanism of: Citalopram Duloxetine Venlafaxine Doxepin Amoxapine Tranylcypromine Isocarboxazid Trazodone, nefazodone
Citalopram - SSRI Duloxetine, venlafaxine - SNRI Doxepin, amoxapine - TCAs Tranylcypromine, Isocarboxazid - MAOIs Trazodone, nefazodone - 5HT modulators (insomnia)
What are the 2 indications for SSRIs?
Depression and anxiety disorders
What are the 2 indications for SNRIs?
Depression and chronic neuropathic pain (fibromyalgia)
What are the 3 effects of TCA OD?
“Tri-Cs” - Cadiotoxicity (arrhythmias), CNS toxicity (coma, seizures), and antiCholinergics
Most common cause of death = arrhythmias
When is Bupropion contraindicated?
Bulemics - can cause seizures
What is the best drug therapy for depression in a little old lady that isn’t eating well?
Mirtazapine - can cause weight gain
What is the other side effect of Mirtazapine that may actually help depression symptoms?
Sedation - may improve sleep
What is the most common use for Trazodone?
What is the most serious side effect?
Insomnia (5HT modulator)
Priapism
What antidepressant is used to treat:
Fibromyalgia
OCD
Nocturnal enuresis
Fibromyalgia - amitryptiline
OCD - clomipramine
Nocturnal enuresis - imipramine
Indication for buspirone (5HT agonist)
Indication for bupropion (NDRI)
Generalized anxiety disorder
Smoking cessation
What’s the difference between GAD and adjustment disorder?
GAD is > 6 mo
Adjustment disorder is
What causes narcolepsy?
Decreased orexin (hypocretin) production in the lateral hypothalamus - normally suppresses REM
What 2 drugs can be used to treat narcolepsy?
Amphetamines or modafinil (non-amphetamine stimulant)
What personality disorder is associated with:
Projection
Increased suicide rate/self mutilation
Splitting
Projection - paranoid
Increased suicide rate, splitting - borderline
How can you distinguish Neuroleptic Malignant Syndrome and Serotonin Syndrome?
NMS = rigidity SS = myoclonus