Psychology Flashcards
Acute Serotonin Syndrome
Occurs from high levels of serotonin accumulating in the body due to the introduction of a new drug (drug interaction) or an increase in the dose. Has acute onset (60% of cases occur within 6 hours of change in dose or overdose) with rapid progression
Hunter Toxicity Criteria Decision Rules for determining serotonin syndrome
Has taken a serotonergic agent and meet one of the following conditions:
- change in mental state,
- spontaneous clonus
- inducible clonus plus agitation and diaphoresis
- ocular clonus plus agitation or diaphoresis
- tremor plus hyperreflexia or hypertonia
- temperature >100.4°F (38°C) plus ocular clonus or inducible clonus.
When switching serotonin drugs how long should you wait between stopping one and starting another?
2 weeks for washout
Malignant Neuroleptic Syndrome S/S
Caused by some antiphsychotics
high fever, muscular rigidity, bradykinesia, mental status changes, dysautonomia (fluctuating blood pressure [BP]), and urinary incontinence.
Look for a history of mental illness and prescription of an antipsychotic(s). This is a potentially life-threatening reaction. Refer to ED or call 911.
MMSE
Maximum score is 30 correctly done; a score of <19 indicates impairment.
SSRIs are first line treatment for…
Major depression,
Obsessive-compulsive disorder (OCD)
Generalized anxiety disorder,
panic disorder,
social anxiety disorder
Premenstrual dysphoric disorder
PTSD
Fluoxetine (Prozac):
Longest half-life of all SSRIs and the first SSRI (useful for noncompliant patients)
TCAs are used for …
herpetic neuralgia and for migraine headache prophylaxis
Do not give to suicidal patient. Hoarding and overdose causes fatal cardiac arrythmia.
Citalopram (Celexa):
Has fewer drug interactions compared with other SSRIs
People on MAOIs should avoid…
Foods high in tyramine:
fermented foods such as beer, Chianti wine, some aged cheeses, fava beans.
Can cause elevated BP and risk for stroke.
Examples of MAOIs
isocarboxazid, phenelzine, selegiline, and tranylcypromine
Labs for alcoholism
GGT elevation can be a sign of occult alcohol abuse.
AST/ALT ratio of 2.0 or higher is more likely in alcoholism.
Medications for alcohol abuse
Disulfiram (Antabuse): Causes severe nausea/vomiting, headache, other unpleasant effects
Naltrexone (Vivitrol): Decreases alcohol cravings
Korsakoff’s Syndrome
A complication from chronic alcohol abuse. A neurologic disorder with symptoms that include hypotension, visual impairment, and coma. Signs include mental confusion, ataxia, stupor, coma, and hypotension. Treated with high-dose parenteral vitamins, especially thiamine (vitamin B1).
Medication indicated for eating disorders
Bupropion (Wellbutrin)
