Psych Flashcards
Parkinsonian Disease Dementia
similar to Lewy Body Dementia, BUT parkinson symptoms of tremor and rigidity >1 yr precede the cognitive impairment
Lewy Body Dementia
has to have >2 of the following visual hallucination parkinsonism (at the same time as dementia!) sleep disorder fluctuating cognition
progressive supranuclear palsy
falls
impaired gaze
parkinsonism
**very rare
best treatment for ACUTE bipolar mania
1st of 2nd gen antipsychotics
olanzapine can be given IM and acts rapidly
best treatment for ACUTE bipolar depression
Lamotrigine
DO NOT do an antidepressant in BPD
delusion disorder
> /=1 delusion for >/= 1 month
there is lack of any other psychosis
aka pt is functioning normally otherwise
Schitzophreniform vs Schitzophrenia
phreniform is >1 mo <6 mo
phrenia is >6 mo
smoking cessation drugs
Varencycline
Buproprion
Nicotine aids
PCP
= phencyclidine
side effects are hypertension, hyperthermia, muscle rigidity
causes hallucinations, nystagmus, and lack of pain sensation
ADHD
inattention
and hyperactive/impulse symptoms
in >1 place
whats dialectical behavioral therapy for?
BPD
whats biofeedback therapy?
- therapy to get attuned to the physical symptoms like BP and HR and learn how to respond and control physiologic reactions
psychodynamic psychotherapy
gain insight into past events and see how that effects events of today
Aripripazole MOA
partial agonist and antagonist of D2.
what drugs increase Lithium levels?
thiazides, ACEinhibitors, NSAIDs, metronidazole, tetracyclines
Lithium toxicity symptoms?
GI distress tremor ataxia agitation confusion
serotonin syndrome vs NMS symptoms
serotonin- GI distress, muscular hyperactivity/reflexivity, low grade fever
NMS- muscular rigidity with low reflexes, HIGH fever
Bipolar long term treatment
Lithium
Valproate
Qietapine
Lamotrigine
how does Risperidone work?
antagonist of D2 and serotonin
T/F Buproprion 1st line antidepressant?
YES
catatonia treatment?
Benzodiazepine, then ECT if that doesnt work in one week
schitzophrenia vs schitzoaffective vs Bipolar disorder
phrenia: psychotic features mainly with only few instances of psychotic w mood
affective: psychotic with mood disorder
BPD: never any psychotic features without mood
bipolar disease long term pharmacotherapy
lithium or valproate
olanzapine precautions
metabolic syndrome concern (similar to Clozapine)
check lipids, triglycerides, weight
which psych med req close cbc monitoring
Clozapine
- concern for agranulocytosis
treatment for acute dystonia
benzotropine
antihistamine
treatment for akathesia
benzotropine
lorazepam
B Blocker
treatment for drug induced parkinsonism
benzotropine
amantidine
treatment for TD
Valbenazine
schitzophrenia vs schitzophreniform
< 6 mo vs >6 mo
to treat psychotic symptoms secondary to parkinson’s drugs give what?
quietapine or clozapine or pimavanserin
what is progresssive supranuclear palsy
falls, impaired vertical gaze, parkinsonism
how to tell apart Lewy Body Dementia and PD Dementia
PD Dementia- the parkinsonian symptoms come before the dementia (>1 yr before)
Lewy Body Dementia: both dementia and Parkinson sx without time gap in betwen
somatic symptom vs illness anxiety
somatic symptom is concern and worry about 1+ unconcerning nonspecific sx
illness anx is concern you are ILL even though you have minima sx
OCD vs OCPD
OCD: true obsessions followed by compulsion which are distressing to pt
OCPD: perfectionism to the point of ineffectiveness which are non distressing
drinking cut offs for alcoholism
women or elderly men who drink >7 a week and >3 in a day
men <65 who drink >14 a week and >4 day
nightmare disorder vs sleep terror disorder
nightmare happens in REM, pt remembers the dream, and is consolable
sleep terror happens in Non-REM, pt does not remember the dream and is not consolable
pediatric depression treatment
SSRI- fluoexetine
Buproprion is not first line or used frequently in pediatrics
oppositional disorder vs conduct disorder
oppositional can PRECEDE conduct and is less severe. Conduct involves violating the rights of OTHERS
seizure vs DT timeline in alc withdrawal
seizures in 24-48 hr
DT in 2-4 days
why is Lorazepam preferred for stopping seizures over Diazepam and Chordiazepoxide
it is intermediate acting the others are long acting
it does not get metabolized by the liver
abnormalities related to anorexia nervosa
hypercholesterolemia, hypercarotenemia, decreased bone mineral density, decreased HPO axis,
acute bipolar depression tx
lurasidone, qeitiapine, lamotrigine
patient on long term opioids must be seen how often
every 3 mo
tx for post partum depression in breastfeeding mom
sertraline
NMS pharm tx
stop antipsychotic
give amantidine or bromocriptine or dantrolene
acute stress disorder vs PTSD timeframe
3 d-1 mo vs >1 mo
SSRI with lowest cardiac risk
sertraline and escitalopram
how long should someone be on ssri
if single episode of MDD, do 6 mo after acute phase
if multiple episodes etc do 1-3 yrs
if v serious with multiple suicide attemps to indefinitely
what are the signs and symptoms of Li toxicity
GI distress
tremor and fasciculation
confusion and ataxia
(nte the risk of this is increased with NSAIDs, ACEi, ibuprofen)
which antidepressants can cause hypertension
SNRIs like Venlafaxine can cause DOSE dependent hypertension. at low doses serotonin affects predominate but as the dose increases norepinephrine effects increase
how do you switch from an SSRI to an MAOi
stop SSRi for 2 wks minimum before starting MAOi
reason being is that MAOi can inhibit the ox deamination of serotonin and increase its levels and cause serotonin syndrome
symptoms of serotonin syndrome?
tachycardia, hyperreflexia, dilated pupils, tremor, hyperthermia, tremor
MDD physiology
increased cortisol levels due to HPA hyperactivity
lactate infusion sensitivity assn w what psych dx
Panic disorder
medication tx for OCD
SSRI clomipramine
what is anxiety re public speaking
it is a SOCIAL phobia not a specific phobia
after what age is bedwetting pathological
> 5 yo
