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Psych Bullets Flashcards

1
Q

Serenase (Haloperidol)

Antipsychotic - downer

A

Block post synaptic uptake of dopamine in the brain

Treatment for Tourette syndrome, psychosis, autism

S/E

Orthostatic Hypotension (ECG)

Decrease excretion of TB drugs - toxicity

Anti-cholinergic
Blurring of vision
Constipation
Drowsiness
EPS
-Tardive dyskinesia (after 8mos: late sign)
-Pseudoparkinsonism (reversible)
Foto sensitivity
aGranulocytosis
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2
Q

MAOI - upper

EMsam
PArnate
NArdil
MArplan

A

Inhibits destruction of amines in the brain

Oral- Avoid tyramine rich
FPS BAR
Patch - no food restriction; rapid absorption

No downer - decrease effect
No upper - increase effect

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3
Q

Phenytoin (Dilantin)

Anxiolytic - downer

A

Normal serum level 10-20ng (>20 toxicity)
Administer 35-45mg/minute (>45 r/f toxicity)
Can only be mixed with PNSS

Toxicity (HANG)
Early
-Hirsutism
-Ataxia
-Nystagmus
Late
-Gingival hyperplasia/Gingivitis
Fatal
-arrhythmia

WOF bone marriw depression
Agranulocytosis

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4
Q

Valproic acid (Depakene/Depakote)

Mood stabilizer - downer
Secondary drug for mania

A

Teratogenic

Small doses for elderly (hepatotoxic)
R/f pancreatitis
R/f drowsiness

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5
Q

Garlic

A

HPN
Hyperlipidemia
No anticoagulants

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6
Q

Ginseng

A

Stimulates adrenal medulla (⬆️ epi/norepi)
For narcolepsy
Vasodilator - erectile dysfunction (30 minutes before sex)
⬇️glucose - DM 2 (check CBG before)
No anticoagulants
May induce mania episode

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7
Q

Ginger

A

Sore throat - antiseptic
Bowel spasm - vasodilation
No anticiagulants

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8
Q

Gingko biloba

A

Vasodilator
Brain enhancing agent
No anticoagulants

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9
Q

Grape seeds

A

Vasodilator
Antioxidant
For skin integrity
No anticoagulants

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10
Q

Fever few

A

For migraine

Taper before discontinuing

No anticoagulants

Ask for allergy with yarrow ragweed and chamomile

WOF feverfew syndrome eg headaches

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11
Q

Clozapine (Clozaril)
Atypical antipsychotics
Downer

A

Treats (+) and (-) symptoms

Ambivalence
Anhedonia
Ideas of reference
Delusion of grandiosity
Command hallucinations 
Avolition
Alogia
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12
Q

auditory hallucination

A 
Staring blankly on the wall
Looking in the corner of the eyes
Sudden shouting during the conversation with the nurse
Interference of verbalization
Mumbling of words when he/she is alone
Looking up and to the side

Say "NO" to the voices
Reality based activity (playing cards)
Voice hearers support group
Divert attention: invite for a walk
Use mobile phone to conceal hallucination
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13
Q

Munchausen syndrome by proxy

A

Common abusers : parents/ caregiver (rescuer complex)
It’s a form of factitious disorder imposed by another individual
Abusers are knowledgeable about medical and pharm treatment
Commonly affected individuals are <6yo
S/sx doesn’t coincide with story of the abusive mother
Frequently the abuser have history of munchausen syndrome
Survivors become abusers
Therapy should be done for abused and abuser separately

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14
Q

TCA
-tryptiline
Anti depressant - upper

A

Inhibits reuptake of:
Norepinephrine
Serotonin

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15
Q

SSRI

Upper - anti depressant

A

Prevents reuptake of serotonin

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16
Q

Clients intentionally hurt themselves

A

Munchausen syndrome

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17
Q

Conscious way of faking physical and emotional symptoms in order to assume sick role

A

Malingering

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18
Q

Warning sugns of munchausen syndrome by proxy

A

Multiple history of clinic visits and hospitalization
Reports doesn’t correlate with lab results
Blood in urine doesn’t match patient’s
Illicit substances/chemicals found in stool, blood and urine
Report of worsening of symptoms are not ibserved by nurse

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19
Q

Dissociative disorder

A

Defense mech
Suppression
Isolation

Caused by psychological trauma which could alter the memory, awareness, identity and perception of the client

Episodic memory loss
Selective reversible amnesia
Tx hypnotic therapy

Dissociative fugue - out of body experience

Dissociative identity disorder- no sense of identity

Derealization - perception that the environment is fake

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20
Q

anti social

A 
Low self esteem
Rationalization
Coprolalia
Harm directed to others
Disinhibition

Firm casual indifference approach
Never negotiate
Tell pt. to verbalize feelings rather than acting out
X group therapy when agitated

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21
Q

Alzheimer’s disease

A 
⬇️ acetylcholine
DOC : anti cholinesterase
Tacrine (Cognex)
3rd/4th stage at custodian care
Monitor during sundowning (DOC Ativan/ Oxazepam)

Stages 
1 asymptomatic
2 easy forgetfulness
3/4 regression
       - hyperorality - blabbers
       - astereognosia
       - alexia ( can't write)
       - hyperetamorphosis (exaggerated words)
       - perseveration (repeating answers)
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22
Q

Lorazepam (Ativan)

A 
Increases GABA (PNS)
For delirium tremens
Epilepsy and seizure dso
Pre op meds
Muscle relaxant
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23
Q

DOC for alcohol dependence

A

Disulfiram antabuse

X alcohol 12-24hrs before taking it

X mouthwash
X fermented

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24
Q

Buspar (BUSpirone Hcl)

Atypical anti psychotics

A

Hepatotoxic

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25
Methyphenidate (Ritalin) | ADHD - stimulant
``` Narcolepsy Avoid stimulants Avoid sharing Don't crush S/e wt loss and anorexia Give at AM PC Report signs of psychosis ```
26
Lithium Anti manic Bipolar disorder
``` Nephrotoxic Adequate salt X sweating X diuretics X DHN Check lithium levels everyday ``` ``` TOXICITY Early (GIT) - diarrhea - polyuria - diaphoresis - gastric upset - dry mouth Late (Neuro) - CNS depression - ataxia - neuromuscular irritability - fine hand tremors - jerky movements - seizure ```
27
Narcotics - downer
Opiate analgesics Toxicity: pin point pupils Antidote: naloxone/narcan Morohine ok for pancreatitis Hydrocodone : antitussive Methdone prevents withdrawal syndrome Monitor for drowsiness
28
Hallucinogen - stimulants
CUSH/ HUSHISH/CANNABIS - red eyes and increase appetite Lysergic Acid Diethylmide - acidify urine Intoxication: small doses of diazepam/neuroleptics Chronic use: psychoses, depersonalization, beligerence
29
PTSD
DOC: Antidepressant SSRI/TCA ``` Hypervigilance Alertness Paranoia Depression Guilt trauma Recurrence of events Problems with sleeping patterns Common cause - female: rape - male: mauling/violence ```
30
Tardive dyskinesia
Smacking lips Grinding teeth (bruxism) Flycatching/vermiform/wormlike tongue Manifest after 8mos Irreversible
31
Dystonia
Appears as soon as one day after antipsychotics
32
Dopaminergics HT
``` Decrease protein in diet X Pyridoxine (antagonize the drug) ``` Chevk for recurrence of psychotic episodes DOC for gynecomastia X for lactating women
33
Alcohol withdrawal priorities D&D
``` Seizure/ jerky movements Changes and sensorium and hallucinations Elevated PR and BP Hypertension Nausea and vomiting Hyperalertness/irritability Sweating ```
34
Abuser | After feels
Powerful In control of everything Wife deserves to be abused
35
Negative symptoms
``` Depression Anhedonia Alogia Avolition Anergia Thought block ```
36
Positive symptoms
Ambivalence Agression Association looseness Affect disturbance
37
Alcohol containing products | X for aversion tx
``` Vinegar Cough syrups Mouth wash Aftershave Syrups Left over rice(sake) ```
38
Autism
Can still go to school but with specialized supervision Tantrums increase as the child gets older Do not touch when agitated Care and rehabilitation for caregivers and patient Mgt Pleasurable motor and sensory stimulation Behavior modification Teach family to identify excessive stress and coping skills Encourage self-care
39
Restraints
Initial - least invasive Chemical tranquilizers alter concentration and judgement Applied when interfering with treatment and procedures Should be released every 2 hours for 15-30 minutes Renew order every 24hrs
40
Orthostatic hypotension due to psychiatric meds
Slowly rise up from lying or sitting position Dec. OFI at night to avoid getting up at night Mount parallel bars on walls and assist during ambulation Call bed at bed side Do not raise legs
41
Echinecea
Immune booster - for immunosuppressed pts Do not take for more than 8wks It can cause rebound immunosuppression
42
Milk thistle
Silimarin Hepatoprotective Antioxidant
43
Bipolar type 1
``` Impulsivity Demanding Eating and sleeping very little Hyperactivity Lack of remorse ```
44
Depression
Self mutilation Somnolent detachment Pseudo Dementia Introjection
45
ECT
Consent and pre-procedure teaching to patient Succinylcholine - pre-ECT Meds to control seizure and spasm Remove jewelries X for post ORIF patients Most effective for depression Void before ECT Memory loss is common. Return after 2-4 wks
46
2nd tri pregnant with mania
ECT MgSo4 Psychotherapy
47
Heroine related diseases
``` Hepatitis AIDS Endocarditis Tetanus Leukoencephalopathy Blood clots ```
48
Saw palmetto
For BPH ⬇️dihydrotestosterone (DHT) R/f impotence ⬇️libido
49
Common disease of african americans
``` Hypertension d/t their hyperviscous blood ⬇️med metabolism DM Coronary Artery Disease HIV Drug intoxication Ebola Parasitism ```
50
Race with lactos intolerance
Asians | Hispanic
51
Muslim
Post mortem care Cover with white cloth Side lying facing towards mecca Same religion nurse to care for client Diet Halal: ritually slaughtered and prepared X birds of prey X pork Leader Imams
52
Normal geriatric changes
``` Lentigo- liver spots Hypothermia - ⬇️ability to chill ⬇️height - 60yo 1cm (kyphosis) ⬇️gustatory sensation (make food appetizing) ⬇️ GUT Frequency r/f UTI ```
53
Reducing communication barriers
Use language educational level appropriate (english speakers) Use an interpreter (x relative/friend) Clarify slang terms
54
Hearing impairment | D&D
``` ✔️ functional hearing aid ✔️ if can lip read Stand in front of the client Use simple familiar words with low tone voice Relay info thru writing ```
55
Sees eye contact as disrespectful
``` Brazilian Asians African American Native Americans Appalachians (native alaskan) ```
56
Sees eye contact as a sign of trustworthiness
Europeans
57
Warning signs of suicide
``` Giving away prized possessions Organizing affairs (goodbyes) Too many requests and wishes (death wish) Sudden feelings of anxiety Withdraws from crowd Covert messages (sentimental) Sudden cheerfulness ```
58
anorexia nervosa
``` Complications Hypoalbuminemia Hypokalemia Dehydration Gastric Ulcers ⬇️left ventricular mass ``` ``` Criteria for hospitalization Wt. loss of >15% Persistent bradycardia Temp <97F Hypotension (S <90mmHg) Suicidal ideation Resolute reluctance of the condition ```
59
Mania
High caloric finger foods X overstimulation ✔️calm environment Neutral attitude approach without power struggles
60
Seasonal Affective Disorder
Depression during winter (mood fluctuations) Incidence increases d/t lack of direct light Predisposed by altered melatonin production Commin in alaska norway and some in asia Primary treatment: phototherapy

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