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Psychiatry Shelf > Psychopharm > Flashcards

Psychopharm Flashcards

1
Q

lithium tox - sx, tx

A

nausea, vomiting, slurred speech, ataxia, incoordination, myoclonus, hyperreflexia, seizures, delirium, coma, nephro DI
hydrate dialysis

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2
Q

TCA tox - sx, tx

A

ACh, cardiac issues, hypotension, respiratory depression, agitation, hallucinations, CNS stim, depression, seizures

monitor EKG, give bicarb activated charcoal, cathartics, supportive treatment

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3
Q

meds that can cause psychosis

A

corticosteroids, antiparinson, anticonvulsants, antihistamines, anticholinergic, antihypertensives, dig, methylphenidate, fluoroquinolones

  • alchol, cocaine, hallucinogens, marijuana, benzos, barbs, PCP
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4
Q

drug that causes irreversible retinal pigmentation

A

thioridazine

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5
Q

drug that causes agranulocytosis

A

clozapine

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6
Q

litihium - side effects

A 
weight gain
tremor
GI
fatigue
cardiac arrhythmias
seizures
goiter
leukocytosis
coma
polyuria
polydipsia
alopecia
metallic taste
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7
Q

disulfiram

A

blocks aldehyde dehydrogenase, so causes hangover in patients,

contraindicated - cardiac disease, pregnancy, psychosis

monitor liver function

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8
Q

naltrexone

A

opioid receptor blocker

decreases craving

good for patients with hisotry of alcohol abuse

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9
Q

acamprosate

A

postdetox for relapse prevention

used in patients with liver disease

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10
Q

topiramate

A

anticonvulsant that potentiates GABA, inhibits glutamate recetpors

reduces cravings for alcohol

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11
Q

drug that mimics schizo

A

amphetamine psychosis

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12
Q

flumazenil

A

benzo antagonist short acting for overdose

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13
Q

barb overdose treatment

A

alkalinize urine with sodium bicarb to promote renal excretion

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14
Q

naloxone

A

treatment of choice for opiate overdose

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15
Q

opioid producing large pupils

A

demerol dilates pupils

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16
Q

opioid overdose mnemonic

A

Rebels Admire Morphine

respiratory depression
AMS
Miosis

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17
Q

methadone

A

long acting opioid receptor agonist

  • use in pregnant women
  • can cause QTc prolongation
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18
Q

buprenorphine

A

partial opioid receptor agonist

  • suboxone
  • overdose unlikely
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19
Q

TCA use in elderly

A

nortriptyline, fewest anticholinergic

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20
Q

primary tx of depression in elderly

A

SSRIs

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21
Q

tx of tourette’s disorder

A

psychopharm

- atypical antipsych, alpha 2 agonists, typical antipsych

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22
Q

tx of depersonalization

A

antianxiety agents or SSRIs for anxiety or depression

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23
Q

tx of pain syndrome

A

SSRI, biofeedback, hypnosis, psychotherapy

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24
Q

tx of explosive anger

A

SSRI, anticonvulsant, lithium, propranolol

- loiw levels of serotonin

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25
Q

anti histamine side effects

A

sedation, weight gain

in TCA, low potency antipsych

26
Q

anti adrenergic side effects

A

hypotension

in TCA, low potency antipsych

27
Q

anti muscarinic side effects

A

dry mouth, blurred vision, urinary retention

in TCA, low potency antipsych

28
Q

foods with tyramine

A

red wine, cheese, chicken liver, cured meats

29
Q

tx/cause of EPS

A

benztropine, high potency antipsych

30
Q

CYP450 inducers (4)

A

smoking (1A2), carbamazepine (1A2, 2C9, 3A4), barbiturates (2C9), st john’s wort (2C`9, 3A4)

31
Q

CYP450 inhibitors (5)

A

fluvoxamine (1A2, 2D6, 3A4), fluoxetine (2C19, 2C9, 2D6), paroxetine (2D6), duloxetine (2D6), sertraline (2C19)

32
Q

time course of antidepressants

A

1-2 months

33
Q

SSRI approved for OCD

A

fluvoxamine

34
Q

drug used to augment sexual side effects of SSRIs

A

buproprion

35
Q

side effects of SSRIs

A

sexual dysfunction, GI disturbance, insomnia, HA, anorexia, weight loss, restlessness

can increase warfarin

36
Q

drug used for people with depression and neuropathic pain

A

duloxetine

37
Q

venlafaxine caution

A

can increase blood pressure, do not use with labile BP

38
Q

side effects of trazodone

A

priapism, sedation, orthostatic hypotension

39
Q

amitriptyline use

A

chronic pain, migraines, insomnia

40
Q

imipramine use

A

enuresis, panic disorder

41
Q

clomipramine use

A

most serotonin, useful in OCD

42
Q

doxepin use

A

chronic pain

43
Q

TCA overdose tx

A

sodium bicarb

44
Q

nortriptyline use

A

chronic pain, less likely to cause orthostatic hypotension

45
Q

desipramine use

A

less sedating, least anticholinergic

46
Q

complications of TCAs

A

3Cs
- cardiotoxicity, convulsions, coma

lethal in overdose

47
Q

way to avoid serotonin syndrome

A

wait 2 weeks before switching from SSRI to MAOI

48
Q

monitor in lithium patients

A

litihium levels, creatinine, thyroid levels

49
Q

NMS mnemonic

A

FALTERED

Fever
Autonomic instability
Leukocytosis
Tremor
Elevated CPK
Rigidity
Excessive sweating
Delirium
50
Q

tx of EPS

A

benztropine, diphenhydramine, or amantadine

51
Q

mood stabilizer to decrease suicidality

A

lithium

52
Q

antipsych to decrease suicidality

A

clozapine

53
Q

factors that affect lithium levels (7)

A 
NSAIDS (decr)
aspirin
dehydration (incr)
salt deprivation (incr)
sweating (incr)
impaired renal function (incr)
diuretics
54
Q

drug used for treating mixed episodes and rapid cycling bipolar

A

carbamazepine

55
Q

side effect of carbamazepine

A

skin rash, GI, CNS, neural tube defects in pregnancy, leukocytosis (useful with clozapine)

56
Q

valproic acid - use, monitor

A

useful in mixed episodes of bipolar and rapid cycling

monitor - LFTs and CBC

57
Q

lamotrigine - use, side effects

A

bipolar depression use

side effects - stevenws johnson syndrome, dizziness, sedation, headaches, ataxia

58
Q

topiramate - use, side effect

A

impulse control disorder and anxiety

side effect - weight loss, hypochloremic non anion gap metabolic acidosis and kidney stones, hepatotoxicity

59
Q

drug used to reverse benzo overdose

A

flumazenil

60
Q

steps for ECT

A

general anesthesia, muscle relaxant, generalized tonic-clonic seizure

61
Q

transcranial magnetic stimulation (rTMS) side effects

A

headaches, rare seizure

Psychiatry Shelf (3 decks)

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