Psychiatry Flashcards
Which drug would cause:
Malaise, chest pain, sweating, neutropenia
Clozapine
Schizophrenia management
Oral atypical antipsychotics are first like
Side effects atypical antipsychotics
Metabolic side effects
Examples of atypical antipsychotics
Olanzapine, clozapine, risperidone
Side effects of risperidone
Galactorrhoea
Examples of tricyclic antidepressants
Amitriptyline
Side effects of tricyclic antidepressants
Dry mouth
MOA typical antipsychotics
D2 antagonists
Side effects typical antipsychotics
Extrapyramidial (Parkinson’s etc) and hyperptolactinaemia
Examples of typical antipsychotics
Haloperidol and chlorpromazine
Sx lithium toxicity
Tremor
Hyperreflexia
Seixure
Confusion
Management lithium toxicity
Resuscitation with saline
Haemodialysis in severe cases
Precipitating factors of lithium toxicity
Dehydration
Renal failure
Drugs (diuretics, ACEi, NSAIDs)
How do you differentiate between depression and dementia?
Depression has a short, rapid onset and is associated with biological sx like weight loss
Pt is also aware of and worries about memory
Dementia causes recent memory loss, depression is global
PTSD management
Watchful waiting if sx mild and less than 4 weeks
SSRI is first line after social therapies
Which medication can counteract alcohol cravings?
Acamprostate
Pt presents with these sx:
agitation/anxiety, insomnia, hallucinations spasms, dry mouth
Benzo withdrawal
Tricyclic antidepressants MOA
Monoamine uptake inhibitors
E.g tricyclic antidepressants
Amitriptyline
S/e TCAs
Sedation, dry mouth hyponatraemia
Withdrawal sx TCAs
Agitation, sweating, headache
Positive sx schizophrenia
Delusions, hallucinations, thought disorder
Schneider’s first rank sx of schizophrenia
Positive sx of schizophrenia
Primary decisions (appear with no precipitating event)
Persistent delusions (arise with period of perplexity)
Secondary delusions
Negative sx of schizophrenia
Reduced function
Alogia - poverty of speech
Lack of emotion
Lack of interest in life, self care etc
Management schizophrenia
Atypical antipsychotics are first line
Sx PTSD
Flashbacks, hypervigilant
Avoidance behaviour
Treatment for PTSD
CBT
and SSRIs
Treatment for depression
SSRIs
E.g. anti-convulsant
Sodium valproate
Sx serotonin syndrome
Confusion, agitation, seizures
Herbal cause of serotonin syndrom
St John’s Wort
E.g. SSRIs
Fluoxetine (children)
Seetraline
Sx SSRI discontinuation
Dizziness and vertigo
Electric-shock feelings
Flu sx
SNRI e.g.
Venlafaxine
Delerium tremens
Caused by increased alcohol
Sx delirium tremens
Tachycardia, sweating, hallucinations
Tx delerim tremens
Benzodiazepines and thiamine
Lewy Body Dementia sx
Steady decline and visual hallucinations
Tx Lewy Body Dementia
ACHEi - rivastigmine
Fronto-temporal dementia sx
Preserved memory but personality changes and metabolic disorders
Vascular dementia sx
Shuffling gait, neural infarcts
Risk factor vascular dementia
Stroke or TIA
Sx Alzheimer’s
Tau tangles
Slowly progressive memory loss
Tx Alzheimer’s
AChEi
RIvastigmine, donepezil
ADHD tx
Atomoxetine 0 noradrenaline reuptake inhibitor
Citalopram MOA
SSRI
Haloperidol MOA
Dopamine antagonist
First line therapy for ADHD
Methylphenidate - dopamine/norepinephrine reuptake inhibitor
Which antidepressants can you not eat with wine and cheese
MAOI
What happens when you eat wine/cheese when on MAOI
Tachycardia and headache
Schizoid personality disorder
Loss of interest and interaction with others - not related to delusions
First line anti-psychotic for schizophrenia
Risperidone
Is group or individual CBT offered first?
Group - lower intensity
Opiate overdose
Decreased consciousness, decreased HR, RR etc
Withdrawal sx opiate
agitation, goose skin, increased hr and bp
What is acute stress disorder?
Reaction to a traumatic event <4 weeks ago
Difference between PTSD and ACD
PTSD is longer than 4 weeks, ACD is less
Sx acute stress disorder
Intrusive thoughts
Dissociation
-ve mood
Sleep disturbance
Treatment ACD
- CBT
Benzodiazepines
What is agoraphobia?
Fear of open spaces
Diagnosing anorexia
DSM 5 criteria: restriction of energy intake, intense fear of gaining weight, disturbed vision of body
Adult treatment for anorexia
- *CBT-ED
- Maudsley Anorexia Nervosa Treatment
Child treatment for anorexia
- *Anorexia focussed family therapy
- CBT