Psychopharmacology Flashcards

Question

Akathisia caused by what? Feeling of what? Tx?

Answer 1

``` APs, ADs, anxiolytics Inner restlessness-LL, trunk Movement, pacing and restless High dose of high potency antipsychotics Reduce dose if possible, propanolol, benzodiazepines ```

Answer 2

``` Sustained painful muscular spasm, twisted abnormal postures Within 48 hours- 5 days Neck, tongue, jaw Minutes-hours Anticholinergic agent- IM injection ```

Answer 3

Severe muscule rigidity, fever, altered mental state, AN instability, elevated WBC, CPK and LFTs Diazepam- muscle stiffness Dantrolen- malignant hyperthermia Bromocryptine- dopamine agonist

Answer 4

Patients with mental disorder may lose insight and refuse to be assessed/ treatment: psychosis May lose capacity to make judgement for tx: dementia May be at risk- to themselves/ others

Answer 5

Any other hospital patients Section 2,3,4 and 5 Section 37, 41- committed criminal offence

Answer 6

3- 2 doctors, 1 psychiatrist 3 years training--> section 12 approved, 1 AMHP

Answer 7

Suffering from mental disorder Detained in interests of patients own health/ safety or other persons Nature/ degree warrants the detention of the patient in a hospital- informal/ community assessment not appropriate

Answer 8

Refuse admission and/ or tx Does not have capacity to consent for admission and/or tx Self-harm/ suicide, self-neglect, further deterioration, vulnerability/ exploitation Aggression, neglect of minor e.g. children

Answer 9

Section 2- assessment Section 3- admission for tx Section 5(2)- doctor's holding power for detention of patients who are already voluntary patients in hospital

Answer 10

28 days Renewed or extended Section 3 Suffering from a mental disorder that warrants detention for assessment Interests of his own health/ safety/ protection of other persons Informal admission= not appropriate Treatment- during/ following the assessment

Answer 11

To detain someone in hospital for tx Up to 6 months initially Renewed for a further 6 months and then for a year at a time

Answer 12

Detain a person who is a voluntary patient in hospital Psych/ non-psych ward (except A&E) Up to 72 hours Renewed/ extended Section 2 or section 3 Doctors in the team on on-call doctors nominated deputy- nominated by one in charged of tx No- except in emergency under common law

Answer 13

To understand the information Retain the information Use/ weigh the information Communicate the decision

Answer 14

Time and decision specific | Nurses'- 6 hours

Answer 15

Intro, explain purpose, confirm name+ DOB and address, preferred name, mode of referral

Answer 16

Timeline, impairment- domestic/ social/ occupational, risk behaviours, suicide- risk assessment

Answer 17

When first develop difficulties, come into contact with services, previous Ix, admissions, suicidal thoughts, self-harm, attempts

Answer 18

Med/ surgical issues, previous admissions/ operations, head injury, epilepsy etc Current- OTC, herbal preps, date of initiation, compliance, SEs, allergies, adverse effects

Answer 19

Alcohol- CAGE, primacy, tolerance, withdrawal, relief | Drug hx, IV use, complications, previous tx, smoking- pack years

Answer 20

Parents- marital status, ages, relationships | Siblings, children, family hx- issues, suicide, drinking/ psych

Answer 21

Gestation+ development, childhood, schooling, higher education, employment, psychosexual hx Premorbid personality

Answer 22

Police issues | Accomodation, employment, finances, other people, social support, past times, ADLs, driving

Answer 23

``` Neuro exam Blood tests ECG Urine drug screen Urine dipstick, CXR ```

Answer 24

``` Previous violence Relationship of violence--> mental state Lack of supportive relationships Poor concordance with tx, discontinuation/ disengagement Impulsivity Alcohol/ substance abuse Early exposure--> violence Triggers/ changes in behaviour/ mental state prior to previous violence Recent stressors, losses/ threat of loss Factors stopping violence Family/ carers at risk, history of domestic violence Lack of empathy Violence--> personality factors ```

Answer 25

``` Intro Name DOB What led up to overdose What, how much Belief in lethality→ protective factors Who found them What happened after Taken with anything Happened before Leave note/ message/ letter How do you feel now Factors leading to overdose Other symptoms- seeing/ hearing things, outside/ inside head, who are they, what are they saying, control of thoughts, delusions Presenting complaints- mood, concentration, sleep, appetite Social hx- drugs/ history, who at home, job, family/ friends, social support, ADLs, anyone to speak to Self-harm/ suicidal thoughts Physical health Scale of 1-10- do it again Insight Plans going out of here- who’s at home, safe at home? Future plans ```

Answer 26

``` The past The relationship with the therapist The practical effects of a problem How we feel Looking at different ways of thinking ```

Answer 27

Usually on a one-to-one basis Once-a-week for a few months= 8-12 sessions Uses problem-solving Patient will get homework to do For particular aspects of depression Can help to prevent relapse Usual treatment often continues Therapist undergoes supervision; still keeps confidentiality

Answer 28

Prevents serotonin reuptake Sertraline, fluoxetine, escitalopram GI upset, sexual problems

Answer 29

Prevents serotonin and NAD reuptake Venlafaxine, duloxetine GI upset

Answer 30

Blocks alpha receptors to increase monoamines Mirtazapine Drowsiness, weight gain

Answer 31

???? Amitriptyline Anticholinergic effects

Answer 32

A treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain

Answer 33

``` If you have: severe/ life-threatening depression moderate- severe depression- medication and talking therapies haven't helped Catatonia Severe/ long-lasting episode of mania ```