psych Flashcards
brief psychotic disorder
more than 1 psychotic syptoms with onset and remission but less than 1 month
schizophreniform disorder
LESS THAN 6 months duration with schizophrenia symptoms
schizoaffective disorder
schizophrenia and mood disturbance!!! like major depressive or manic disorder
schizophrenia
more than 6 months of illness with 1 month of acute symptoms along with FUNCTIONAL DECLINE!!!!!
at least 1 must be hallucinatino, delusion or disorganized speech. hallucinations or delusions
positive symptoms: hallucinations or delusions
negative: flat emotional affect, social withdrawl, lack of emotional epression, avolition (lack of self motivation), lack of communication poor eye contact silent patients
schizophrenia
less cns gray matter, increased size of ventricles, increased cns dopamine receptors
management of schizophrenia
dopamine reeptor ANTAGONISTS- because schizophrenia has too much dopamine. risperdal, olanzapine,, seroquel- 2nd generation. dopamine AAND seratonnin antagonists!!
1st generaiton: haldol- better for positive symptoms but extrapyramidal symptsom- just blocks CNS dopaine D2 receptors if its first generation
EPS syndrome
rigidity, bradykinesia, tremor, akathisia (Restlessness)
dystonic: trismus, protrusions of tongue facial grimace, torticollois, diff speaking)
GIVE BENADRYL!!!- anticholinergic properties!! -r or benztropine!
tardive dyskinesia: repetitive involuntary movement- extremities- lip smack, teeth grind, rolling of tongue
parkinsonism!!- rigidity, tremors
neuroleptic malig syndrome
common with 1st gen antipsychotis' mental status change, extreme muscle rigid, tremor, tachy, tachypnea, hyperthermia - DUE TO DEpletion of dopamine GIVE BROMOCRIPTINE- dopamine agonist! amantadine, levodopa, caribdopa
clozapine- 2nd generation
causes agranulocytosis!- mointor cbc weekly!! and myocarditis!!
risperdal and geodon
increases prolactin as side effect
lithium
hypothyroidism as side effect
diabetes inspidus, hyperparathyroidis, seizures,arrythmias
MDD
depressed mood or anhedonia or loss of interest in activities with more than 5 associated symptoms ALMOST EVERYDAY - for AT LEAST 2 WEEKS!
cause clinical distress or impairmentw
MDD
categories:
SAD
atypical depression- mood reactivity (incresaed mood in response to positive events)- severe weight gain/appetite increased
melacholia: no mood reactivitiy, anhedonia depression, severe weight loss and loss of appetite
catatonic depression: motor immobility
meds for mdd
antidepressants should be continued for a minimum of 3-6 weeks for efficacy
SSRI
1st line for depression and anxiety
low tox if overdose
avoid citaloopram for patients with long QT syndrome
seratonin syndrome: espif used with MOA- acute ams seizures, restlessness, tremor, hyperthermia, nausea, vomiting, abd pain
SNRI- inhibits serotonin norepi and dopamine reuptake
pristiq, effexor, duloxetine,
helps with pain and fatigue symptoms
TCA
inhibits reuptake of seraotnin and norepinephrine
prolonged Qt interval, anticholinergic effects- sedation, weight gain
bipolar I disorder
more than 1 manic or mixed episodes which often cycles with ocassional depressive eipsodes
1st family member- STRONGEST risk factor
mania: abnormal and eleated, expansive or irritable mood for at least 1 week- marked impairement of social/occupational function
managemenet of bipolar I
mood stablizier: lithium 1st line
depakote, carbamazepine
haldol or benzo if psychosis or agitation, olanzapine
bipolar II
more than 1 hypomanic episode and more than 1 major depressive episode
no mania or mixed episodes
hypomania: 4 days of weird mood BUT NO MARKED IMPAIREMET, no psychotic features no hospitalizations
bipolar II- HAS to have major depressive symptoms whereas bipolar I does not have to have major depressive symptoms!!
