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year 3. > Psych- Tx > Flashcards

Psych- Tx Flashcards

1
Q

Bipolar gold standard tx
and second line

A

Lithium- monitoring required can fuck kidneys and cause hyperparathyroidisn

sodium valproate second line

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2
Q

management of mania/hypomania in bipolar

A

consider stopping antidepressant if the patient takes one; antipsychotic therapy e.g. olanzapine or haloperidol

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3
Q

management of depression in bipolar

A

talking therapies; fluoxetine is the antidepressant of choice

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4
Q

Ed tx

A

Halt weight loss, if weight gain required then aim for 0.5-1.0kg inc per week

Medical stabilisation etc.

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5
Q

Schizophrenia tx guidelines

A

1st line: 2nd generation (atypical) 6-8 weeks + cbt

2: 1/2nd generation 6-8 weeks

3: check diagnosis, consider psychological input, optimise social support, check compliance

monitor CVD risks

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6
Q

First time pharmacological treatment for depression
how long should it be prescribed minimum

A

SSRIs- fluoxetine

at least 6 months post remission

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7
Q

Depression management

A

1:Watchful waiting 2 weeks
2: Group cbt/digital CBT, non directive supportive tx for 2-3months
3: Individual cbt, …
4th: fluxetine
5th: Sertraline or citalopram (SSRI)

still resistant?- ECT

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8
Q

Ptsd tx

A

1st: CBT
2nd: EMDR (eye therapy thing)

Exposure is key ingredient of successful psychological therapy

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9
Q

Complex ptsd tx

A

Phased treatment;
Stabilisation and safety (resourcing): enhance coping etc

Trauma tx (reprocessing): working through traumatic experience, cptsd

Rehabilitation

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10
Q

Medication for ptsd

A

if used: venlafaxine or SSRI eg. sertraline
severe - risperidone
drug tx should not be a routine first line tx for adults

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11
Q

Ocd mild tx

A

CBT including Exposure and Response Prevention (ERP)

2nd: SSRI or more intense CBT

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12
Q

moderate OCD tx (1st and second line drug)

A

1st: SSRI/ more intensive CBT (including ERP)
2nd line drug- clomipramine

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13
Q

severe OCD tx

A

refer to secondary care mental health team for assessment

whilst awaiting assessment offer combined treatment with an SSRI/clomiparine and CBT (including Exposure Response Prevention)

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14
Q

first line tx for parkinsons with quality of life affected by motor symptoms

A

levodopa

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15
Q

first line tx for parkinsons if motor symptoms are not affecting patients quality of life

A

dopamine agonist
or
levodopa
or
monoamine oxidase

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16
Q

give an example of a short acting benzodiazapene

A

lorazepam

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17
Q

give 2 examples of long acting benzodiazepines

A

chlordiazepoxide and diazepam

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18
Q

alcohol withdrawal tx
first second line

A

1st line: . chlordiazepoxide or diazepam
2nd: carbamezapine (anti-convulsant)

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19
Q

how long should antidepressants be continued

A

at least 6 months after remission of symptoms to decrease risk of relapse

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20
Q

generalised anxiety disorder drug treatment

A

1st line: sertraline
2nd: alternative ssri or SNRI
3rd: if neither SSRI or SNRI tolerated offer pregabalin

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21
Q

generalised anxiety disorder step wise approach

A

step 1: education about GAD + active monitoring
step 2: eg. guided self help
step 3: eg cbt or drug treatment.
step 4: highly specialist input e.g. Multi agency teams

22
Q

SSRIs are associated with inc risk of suicide in the under… agr group. therefore a review must be done within …. of commencing SSRI

A

under 30

review within 1 week of commencing

23
Q

if OCD tx with ssri is effective, how long must it be continued

A

at least 12 months to avoid relapse

24
Q

what type of drug is clomipramine

A

tricyclic antidepressant

25
Q

how do tricyclic antidepressants work and SE

A

inhibit re-uptake of noradrenaline and toa lesser extent serotonin

antagonism of :
histamine receptors (drowsiness),

muscarinic receptors (dry mouth, blurred vision, constipation etc),

adrenergic receptors (postural hypotension)

lengthen QT interval

26
Q

which antipsychotic reduces seizure threshold

A

clozapine

27
Q

which atypical antipsychotic has the most tolerable side effect profile

A

apiprazole- particularly for prolactin elevation

28
Q

give 2 examples of SNRIs

A

duloxetine and venlafaxine

29
Q

what are the risks of SSRI use in pregnancy

A

first trimester -congenital defect (paroxetine inc risk)

use during third trimester can cause persistent pulmonary hypertension of the newborn

30
Q

how often are lithium levels checked

A

lithium levels checked weekly until levels stable, includes after dose change, after stable, check every 3 months

31
Q

panic disorder tx

A

1st line: CBT
2nd: SSRIs
3rd: clomipramine- (tricyclic)

32
Q

escitalopram drug- what is it

A

SSRI

33
Q

what is clomipramine

A

tricyclic antidepressant

34
Q

antipsychotics:
avoidance of EPSE (extrapyramidal side effects)

A

give atypical

35
Q

antipsychotics: less sedating

A

give haloperidol, risperidone

36
Q

antipsychotics: more sedating

A

give Olanzipine, Chlorpromazine.

37
Q

antipsychotics:
Avoidance of weight gain

A

give Haloperidol, Aripiprazole.

38
Q

antipsychotics: treatment resistant

A

give clozapine

39
Q

antipsychotics: depot

A

give risperidone

40
Q

SSRIs se

A

hyponatraemia
sexual dysfunction
worsening symptoms

41
Q

what substances have anti-convulsant properties and therefore can cause…. when suddenly stopped

(non epileptic drugs)

A

benzodiazipines
alcohol

42
Q

heroin overdose tx

A

naloxones

43
Q

paracetamol overdose tx

A

<1 hour - activated charcoal
>1 hour- acetylcysteine

44
Q

absolute contraindication to ECT

A

raised ICP

45
Q

benzos act on what receptor

A

gaba A agonists (increase nurone inhibition)

46
Q

benzodiazapines reversal drug

A

flumazenil

47
Q

what antidepressant has a self harm risk

A

SSRI

48
Q

monamine oxidase inhibitor mechanism of action
se

A

prevents removal of monamines froms ynaptic cleft

can cause hypertensxive crisis if taken with substances contining tyramine eg cheese alcohol

49
Q

serotonin syndrome tx

A

benzo for agitation
sever: ventilation and sedation

50
Q

opiod detox tx

A

methadone full agonist, oral solution

buprenorphine- partial agonist, oral tablet

51
Q

delirium tremens tx

A

long acting benzo eg. chloropioxide

year 3. (32 decks)

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