Psych disorders Flashcards
DEFINE THINCMED in relation to Psychiatric
Tumors
Hormones (thyroid, adrenals, gonadal, insulin)
Infections and immune disease: aids, lyme disease, mono, lupus, syphilis
Nutrition b12, B6, manganese, iron overload
Central Nervous system-head trauma, MS, seizures, parkinsons disease, huntingtons disease
Miscellaneous-sleep apnea, anemia CHF, Wilsons disease
Electrolyte abnormalities and toxins-K na Organophosphates and chemical exposures
Drugs: OTC, homeopathic, prescribed or illicit drugs, also include nicotine and caffeine
define anxiety
a psychological and physical experience of dread foreboding, apprehension or panic in response to emotional or physiologic stimuli maybe acute or chronic
What are common types of anxiety?
acute situational anxiety generalized anxiety disorder panic disorder post traumatic stress disorder obsessive compulsive disorder phobias
what is behavioral therapy
anxiety is the conditioned response to specific environmental stimuli
what are the biologic theories for anxiety?
norepinephrine , serotonin and y aminobutyric acid (GABA) are poorly regulated
automonic nervous system responds inappropriately to stimuli
functional cerebral pathology causes anxiety disorder symptoms
what are organic syndromes that cause anxiety
endocrinopathies, cardio-respiratory disorders, anemia
what other causes trigger anxiety
withdrawal from alcohol, antihypertensive meds
caffeine, cocaine, marijuana corticosteroids, lidocaine oral contraceptives, nsaids, withdrawal from selective serotonin reuptake inhibitors
what is hamilton anxiety scale
The HAM-A was one of the first rating scales developed to measure the severity of anxiety symptoms, and is still widely used today in both clinical and research settings. The scale consists of 14 items, each defined by a series of symptoms,
what is the treatment for acute treatment of GAD
SSRI SNRI
Lexapro, paxil zoloft effexor buspirone
name the brand: buspirone venlafaxine sertraline paroxetine escitalopram
buspar effexor zoloft paxil lexapro
what are TCAs
tricyclic antidepressants such as imipramime
sedating medications for anxiety include:
antipsychotic-trifluoperazine (stelazine)
antihistamine-vistaril (hydroxazine)
antiseizure-lyrica (pregabalin)
What drugs are used for panic disorder
SSRI
TCA
Benzodiazepams
drugs for OCD
SSRI
TCA
DRUGS FOR GAD
SSRI
BUSPAR
BENZOS-can use during pregnancy?
no!
TCA contraindicated in pregnancy
yes!
SSRI contraindicated in pregnancy?
1st trimester only but often continued by ob gyn
diagnostic criteria for agorphobia
avoidance behavior must be associated wtih at least two settings or situations (public places, crowds, mass transportation)
onset of sx with specific circumstances-fears out of proportion to actual danger
may avoid trigger situations
panic disorder: what are the risk factors?
family history, young adulthood, genetic component
may have at least one major depressive episode in lifetime; symptoms are intense, short episodes of panic evel psychological and physical symptoms of anxiety
describe first episode of panic disorder
spontaneous, unexpected and cannot occur when the person is the focus of others attention
what is the second symptom of a panic disorder?
FEAR-SEEK emergency care, life threatening and impending nervous breakdown
what are the symptoms of a panic attack
palpations, pounding heart, accelerated heart rate sweating trembling or shaking sensations of shortness of breath or smothering feeling of choking chest pain of discomfort nausea or abdominal distress feeling dizzy, unsteady, lightheaded or faint derealization or depersonalization fear of losing control of going crazy fear of dying paresthesias chills or hot flushes
what are the 4 criteria of panic disorder
at least one of the attacks has been followed by 1 month or more of one or more of the following
persistent concern about having additional attacks
worry about the implications of an attack or its consequences significant change in behavior related to the attack
not due to ay direct physiologic effect of a substance or a general medical condition
not better accounted for by another mental disorder ocd, ptsd, separation anxiety disorder
what is first line drug regimin for panic disorder
SSRI,SSNI
MAY NEED TO DO A COMBO OF THE TWO
tricyclic, benzo, valproic acid, gabapentin
what anxiety scale is used for ptsd?
Hamilton anxiety scale