Psych

Question 1

what meds would you give to an acutely agitated patient?

Answer 1

benzo (lorazepam) or antipsychotic (haloperidol)

Question 2

first line medications in treatment of alcohol use disorder?

Answer 2

• naltrexone (mu-opioid receptor antagonist)
  
  • hepatotoxic
  • dont use in people who are taking opioids
• acomprosate (glutamate modulator)
  
  • use in people with liver disease or opioid use

Question 3

second line therapy for alcohol abuse disorder only used in highly motivated patients

Answer 3

disulfuram

Question 4

which opioids are detected on UDS?

Answer 4

morphine, heroin, codeine

Question 5

what substance can cause a false positive for PCP on UDS?

Answer 5

dextromethorphan

Question 6

second generation antipsychotic names

Answer 6

ziprasidone, aripirazole, lurasidone, clozapine, olanzapine, quetiapine, risperidone

Question 7

antipsychotic only used in patients who have failed at least 2 antipsychotic trials

Answer 7

clozapine (risk of agranulocytosis)

Question 8

treatment for TCA overdose with prolonged QRS or ventricular arrythmia

Answer 8

IV sodium bicarbonate

Question 9

how does sodium bicarbonate correct prolonged QRS in TCA overdose?

Answer 9

sodium load will alleviate depressant action on myocardium sodium channels

Question 10

what are some medications that can increase lithium levels and cause lithium toxicity (gastrointestinal upset, ataxia, tremor, seizures)?

Answer 10

• thiazide diuretics
• nsaids
• ACE-i
• tetracyclines
• metronidazole

Question 11

pt presents with OD on barbiturates. what do you give them?

Answer 11

sodium bicarbonate; alkalinizes urine which enhances renal excretion of barbiturates