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somatic tx L ques Flashcards

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1
Q

which benzos are metabolized by only glucuronidation (and are therefore not dependent on liver functioning)?

A

LOT

lorazepam
oxazepam
temazepam

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2
Q

if with aripiprazole, get akathisia side effect, what should you do?

A

lower dose and see if improves

if symp of akathisia still continue in absence of other EPS, then start beta blocker (propranolol)

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3
Q

benztropine used to treat what EPS

A

EPS such as dystonia or parkinsonism

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4
Q

diphenhydramine useful in what EPS

A

acute dystonias but not akathisia

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5
Q

tx of bipolar depression

A

recommend lithium, lamotrigine, quetiapine first line

valproic acid-second line

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6
Q

what long term side effect of high dose thioridazine?

A

retinal pigmentation

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7
Q

before initiating lithium, what would be minimum lab info that should be obtained

A

serum creatinine, BUN, electrolytes, thyroid studies

to check baseline kidney fxn b/c kidney handles it like sodium

thyroid studies required because lithium inhibits synthesis of thyroid hormone and its release from thyroid

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8
Q

when on lithium, can ibuprofen be prescribed?

A

NSAIDs can cause increase in lithium levels

aspirin and sulindac however don’t affect lithium levels are are safe for use w lithium

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9
Q

lithium toxicity signs

A

at levels around 1.2, experience tremor, nausea, diarrhea, ataxia

this is followed by seizures at 1.5-2, then acute renal failure at level over 2, then coma and death at levels above 2.5

dehydration can lead to lithium toxicity (think viral illness)

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10
Q

what condition is exacerbated by stimulants/methylphenidate

A

tics assoc with Tourette disorder

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11
Q

what meds do you give for Tourette disorder

A

haloperidol

clonidine for mild Tourette’s

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12
Q

what percent pts achieve remission from depression after tx with SSRI

A

30

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13
Q

venlafaxine should not be given in pt w hx of

A

HTN

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14
Q

anticholinergic toxicity with antipsychotics usu presents with

A

delirium

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15
Q

most effec meds for quickly reducing symptoms of GAD

A

benzos

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16
Q

buspirone requires how long for significant improvement of symptoms

A

several weeks

17
Q

one of the most serious potential risks of SSRI exposure during preg is

A

perisstent pulm HTN of newborn

18
Q

anorexia nervosa-pharm tx?

A

none, unless comorbid psychiatric dis like depression or OCD

19
Q

tx of bulimia nervosa

A

SSRI and topiramate

20
Q

neuroleptics are

A

typical antipsychotics

21
Q

mirtazapine MOA

A

central alpha 2 adrenergic antagonist, antag of 5HT2 and 5HT3 receptors and H1 receptors

22
Q

cardiovascular effects of TCAs

A

quinidine-like effect slowing cardiac conduction

23
Q

why is haloperidol given most frequently for agitation in delirium?

A

most potent of the typical antipsychotics, therefore requiring lower doses with fewer anticholinergic or orthostatic side effects

24
Q

risperidone is available

A

not in IM or IV form, so can’t be given for delirium

25
Q

trazodone should be used cautiously in what pts

A

those at risk for falls b/c blocks alpha 1 adrenergic receptors so can cause orthostatic hypotension

26
Q

why should second gen antipsy be used sparingly in geriatric population?

A

black box warning aout risk of sudden death in elderly pts with dementia related psychosis

27
Q

heroin detox-use what med

A

buprenoprhine

28
Q

which antipsychotic causes galactorrhea moreso than others?

A

risperidone

29
Q

which bipolar med has warning of increased risk of pancreatitis

A

valproic acid

30
Q

most dangerous side effect of lamotrigine

A

SJS (so begin low and slowly increase)

31
Q

bupropion can worsen anxiety: true or false

A

true

32
Q

venlafaxine can increase BP: true or false

A

true

33
Q

topiramate side effect

A

renal stones
weight loss
cognitive slowing

34
Q

obstructive jaundice occurs w

A

chlorpromazine

35
Q

orthostatic hypotension is esp troublseome w what two meds

A

chlorpromazine, clozapine

36
Q

DT in alc withdrawal usu occurs within what time frame post withdrawal?

A

3 days

37
Q

nausea, weakness, confusion

A

symptoms of hyponatremia, relatively common side effect of ocarbazepine

Psych (20 decks)

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