Psych Pharm (not covered in other categories) Flashcards
(PPP 571)
what is the only antidepressant approved for treatment of bulimia?
fluoxetine
(RoshReview)
what SSRI has the longest half-life?
fluoxetine
(Rosh Review)
if a pt has a hx of chronic kidney disease, which is a contraindication for lithium, then ________________ is the recommended antimanic (mood-stabilizing) medication.
valproate
(RoshReview)
what mood stabilizer is contraindicated in pts with CKD?
lithium
(RoshReview)
what are rare adverse effects that may occur due to valproate use?
hepatotoxicity,
thrombocytopenia,
and pancreatitis
(RoshReview)
pts who take valproate have to have what labs checked? and how often?
liver enzymes (AST, ALT) platelets
every 6-12 months
(RoshReview)
valproate is contraindicated for….who?
women who could possibly become pregnant due to the possibility of teratogenicity
(RoshReview)
four uses for valproate
mania
TBI-related agitation (off-label)
sz
status epilepticus
(RoshReview)
if a pt presents with s/s of OCD and would prefer pharmacologic therapy rather than CBT, what would be the most appropriate first-line agent?
sertraline
initial pharm treatment is a SSRI (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)
(RoshReview)
“How long should patients with OCD and a positive response to pharmacologic therapy remain on medication?”
“at least 1 year”
(RoshReview)
define serotonin syndrome
rapid onset
combination of 2+ serotonin agonists or dosage changes
(RoshReview)
three common categories of serotonin syndrome symptoms:
MENTAL STATUS CHANGES (agitation, pressured speech)
AUTONOMIC INSTABILITY (tachycardia, diarrhea, shivering, diaphoresis, mydriasis (WIDE OPEN PUPILS)
NM ABNORMALITIES (clonus, hyperreflexia (lower > upper), tremor, seizure
(RoshReview)
what is the tx for serotonin syndrome?
benzos
hydration/cooling
cyproheptadine
(in that order)
(RoshReview)
“what is the mechanism of action of buspirone?”
blocking 5HT1A autoreceptors
“it affects the serotonergic system by blocking 5HT1A autoreceptors”
(RoshReview)
key differences between NMS and serotonin syndrome?
NMS: more gradual, usually develops over 24 hrs; associated w/ slow NM activity, rather than NM hyperactivity
SS: NM abnormalities = clonus, hyperreflexia, tremor, sz; rapid onset