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Psych rotation 2 (1 is flashcards)

1
Q

Short acting benzodiazepines

A

ATOM

Alprazolam
Triazolam
Oxazepam
Midazolam

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2
Q

Intermediate acting benzodiazepines

A

Tender Loving Care

Tenazepam
Lorazepam
Clonazepam

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3
Q

Long acting benzodiazepines

A

CDeF
Chlordiazepoxide
Diazepam
Flurazepam

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4
Q

MOA of benzodiazepines

A

They increase the FREQUENCY of chloride channel opening –> facilitates inhibitory action of GABA

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5
Q

ADE of benzodiazepines

A

Sedation
tolerance
dependence
ataxia
increased suicide

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6
Q

Contraindications for benzodiazepines

A

suicide risk

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7
Q

caution for benzodiazepines

A

elderly

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8
Q

tx for benzodiazepine overdose

A

flumazenil

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9
Q

how long do you have to have sx before you can be diagnosed with agoraphobia

A

6 months

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10
Q

what is the most common type of phobia

A

social anxiety (disorder) –> social phobia

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11
Q

how long do you have to have sx before you can be diagnosed w social anxiety disorder

A

6 months

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12
Q

what is the mainstay of tx for social anxiety disorder

A

CBT

SSRIs if pharmacologic therapy

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13
Q

tx for performance only social anxiety disorder

A

“as needed”

beta blockers
benzodiazepines

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14
Q

how long do you have to have sx before you can be diagnosed with a specific phobia

A

6 mos

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15
Q

tx for specific phobias

A

exposure and desensitization therapy

short-term benzos or beta blockers in some pts

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16
Q

adjustment disorder

A

maladaptive behavioral or emotional sx develop after a stressful or non-life threatening*** event

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17
Q

when do sx occur and resolve for adjustment disorder

A

within 3 months
resolve within 6 months

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18
Q

how long do you have to have sx to be diagnosed with PTSD

A

sx > 1 month and/or event occurred > 1 month ago

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19
Q

what med can be helpful for ppl with PTSD and insomnia

A

Trazodone

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20
Q

what med can be helpful for ppl w PTSD and nightmares

A

Prazosin

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21
Q

MOA prazosin

A

alpha 1 agonist

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22
Q

Tx for PTSD

A

Psychotherapy

SSRIs and SNRIs first line medical therapy

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23
Q

Sx for serotonin syndrome

A

Anxiety
Agitation
Confusion
N/V
Increased bowel sounds
Diarrhea
Hyperthermia (above 38C)
Clonus
Hypertonia (Increased DTR and hyperreflexia)
Dilated pupils (Mydriasis)

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24
Q

Tx for serotonin syndrome

A

DC med, supportive care, benzos

Cyprohepatine if no response to benzos

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25
Screening for alcohol dependence
CAGE Cutdown Annoyed Guilt Eye opener
26
How many on CAGE to be diagnosed with alcohol dependence
2 or more
27
Recommended limits for alcohol consumption
males 65 or females of any age = less than or equal to 3 standard drinks per day or less than or equal to 7 per week
28
how does the CDC define a drink
12 oz beer 8 oz malt liquor 1.3 oz hard liquor 5 oz wine
29
sx of alcohol intoxication
slurred speech incoordination unsteady gait nystagmus impairment in attention or memory stupor or coma
30
onset of alcohol withdrawal
6-36 hours after last drink
31
sx of alcohol withdrawal
increased CNS activity hand tremor anxiety irritability minor agitation restlessness insomnia diaphoresis palpitations tachycardia hypertension HA GI (N/V diarrhea) alcohol craving loss of appetite
32
sinus tachycardia
>/= 120 BPM
33
onset of alcohol withdrawal seizures
6-48 hours after drinking stops or is significantly reduced
34
onset of alcoholic hallucinations
12-48 hours after last drink and resolves in another 24-48 hours
35
onset of delirium tremens (withdrawal delirium)
2-4 days after last drink
36
difference btwn alcoholic hallucinations and delirium tremens
for delirium tremens, they have abnormal vital signs (tachycardia, HTN, fever, drenching sweats) while ppl w alcoholic hallucinations do not
37
can alcohol withdrawal be fatal
yes
38
tx for alcohol withdrawal
IV benzodiazepines IV fluids, IV thiamine (B1), multivitamin (including B12 and folate) and electrolyte repletion
39
what can reduce the risk of Wernicke encephalopthy
Thiamine (B1)
40
what meds can be used to treat alcohol addiction
Disulfiram Naltrexone Topiramate Gabapentin Acamprosate
41
sx of marijuana intoxication
euphoria giddiness anxiety disinhibition intensification of sensory experiences dry (cotton) mouth increased appetite motor impairment conjunctival injection paranoid delusions hallucinations
42
up to how many days can urine drug test detect cannabis
4-6 days in occasional users up to 50 days in chronic users
43
sx of marijuana withdrawal
irritability insomnia depression restlessness diaphoresis diarrhea twitching
44
what does PCP stand for
Phencyclidine
45
street name for PCP
angel dust
46
MOA PCP
NMDA glutamate receptor antagonist
47
sx of PCP use
hallucinations (visual and auditory) psychosis and delirium psychomotor agitation (movements that have no purpose) nystagmus aggression/violent behavior anesthesia and analgesia marked HTN and tachycardia
48
what will you see on PE for PCP use
multidirectional nystagmus marked HTN and tachycardia dry skin
49
tx for PCP
place in low stimulus environment supportive parenteral benzodiazepines antipsychotics (Haloperidol)
50
most deaths for PCP are related to
trauma - bc PCP is an analgesic and anesthetic
51
what does LSD stand for
lysergic acid diethylamide
52
sx of LSD use
hallucinations (visual and auditory) euphoria depersonalization distrustful
53
does LSD cause dependence of withdrawal
no
54
MOA LSD
action at 5-HT receptor
55
long-term consequences of LSD use
flashbacks years later
56
tx for LSD use
antipsychotics (haloperidol) benzodiazepines supportive counseling
57
common inhalants
toluene butane
58
sx of inhalant
euphoria disorientation slurred speech perinasal and perioral rash/sores
59
tx for inhalant use
no tx/supportive care antipsychotic (haloperidol) if aggressive
60
strong opioid agonists
fentanyl heroin morphine meperidine hydromorphone hydrocodone methadone
61
moderate opioid agonists
oxycodone hydrocodone codeine
62
other opioid agonists (not strong or moderate)
dextromethorphan (antitussive) loperamide and diphenoxylate (antidiarrheal)
63
sx of opioid use
euphoria followed by sedation impaired attention pinpoint pupils constipation hypotension bradycardia seizures
64
triad for opioid intoxication
pinpoint pupils constipation comatose state
65
tx for opioid overdose
naloxone (short-acting)
66
MOA of naloxone
opioid receptor antagonist
67
sx of opioid withdrawal
lacrimation rhinorrhea pruritus N/V abdominal cramping diarrhea sweating yawning joint pain (arthralgia) myalgia dysphoria restlessness piloerection pupillary dilation increased bowel sounds HTN tachycardia
68
is withdrawal from opioids life-threatening
no
69
tx for opioid withdrawal
clonidine methadone buprenorphine + naloxone (Suboxone)
70
MOA clonidine
alpha 2 agonist
71
what is used primarily for sx of opioid withdrawal
clonidine
72
ADE methadone
QT prolongation
73
ADE naltrexone
can precipitate withdrawal if used within 7 days of heroin use
74
sx of benzodiazepines intoxication
loss of coordination (ataxia) anterograde amnesia (inability to form new memories) hypotension bradycardia coma death
75
sx of benzodiazepine withdrawal
anxiety insomnia seizures tremor
76
which benzodiazepines has the higher risk of dependence: short or long acting
short-acting due to shorter half life
77
tx for benzo OD
flumazenil
78
why should you use flumazenil with caution
can cause seizures (just like withdrawal)
79
tx for benzo withdrawal
long-acting benzo
80
describe sx for barbiturate intoxication and withdrawal
v similar to benzos but these are more severe bc no "ceiling"
81
how long should you taper benzos to prevent withdrawal
4-6 weeks
82
what med can be added during benzodiazepine taper
anti seizure meds (Carbamazepine or phenobarbital)
83
what is the major metabolite of cocaine
benzoylecgonine
84
sx of cocaine intoxication
decreased appetite pupillary dilation HTN angina placental infarction nasal septum perforation stroke/CVA tachycardia/tachydysrhytmias hyperthermia cold sweats agitation and aggression stereotyped behavior (repetitive motions)
85
cocaine withdrawal sx
severe depression and suicidality hyperphagia fatigue severe craving constricted pupils
86
tx for cocaine intoxication
benzos antipsychotics are second line
87
what promotes excretion of cocaine
vitamin C
88
why should you not restrain pts w cocaine intoxication
can cause rhabdo
89
MOA cocaine
inhibition of reuptake of dopamine, NE, and E
90
how long is cocaine detected in urine
2-4 days up to 2 weeks in chronic users
91
symptomatic or refractory HTN caused by cocaine can be treated with
phentolamine (alpha adrenergic antagonist)
92
ADE of varenicline
nausea (MC) increased suicidality or neuropsychiatric conditions
93
when should therapy of varenicline begin and end
start 1 week prior to quitting and continue 4 months after quit date
94
MOA varenicline
blocks nicotine receptors partial agonist of alpha 4 beta 2 nicotinic receptors --> prevents reward and withdrawal
95
5 A's for assessing for tobacco use and addressing smoking cessation (in order)
ask advise assess assist arrange

EOR Psych (8 decks)

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