somatic tx L ques Flashcards
which benzos are metabolized by only glucuronidation (and are therefore not dependent on liver functioning)?
LOT
lorazepam
oxazepam
temazepam
if with aripiprazole, get akathisia side effect, what should you do?
lower dose and see if improves
if symp of akathisia still continue in absence of other EPS, then start beta blocker (propranolol)
benztropine used to treat what EPS
EPS such as dystonia or parkinsonism
diphenhydramine useful in what EPS
acute dystonias but not akathisia
tx of bipolar depression
recommend lithium, lamotrigine, quetiapine first line
valproic acid-second line
what long term side effect of high dose thioridazine?
retinal pigmentation
before initiating lithium, what would be minimum lab info that should be obtained
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
when on lithium, can ibuprofen be prescribed?
NSAIDs can cause increase in lithium levels
aspirin and sulindac however don’t affect lithium levels are are safe for use w lithium
lithium toxicity signs
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)
what condition is exacerbated by stimulants/methylphenidate
tics assoc with Tourette disorder
what meds do you give for Tourette disorder
haloperidol
clonidine for mild Tourette’s
what percent pts achieve remission from depression after tx with SSRI
30
venlafaxine should not be given in pt w hx of
HTN
anticholinergic toxicity with antipsychotics usu presents with
delirium
most effec meds for quickly reducing symptoms of GAD
benzos
buspirone requires how long for significant improvement of symptoms
several weeks
one of the most serious potential risks of SSRI exposure during preg is
perisstent pulm HTN of newborn
anorexia nervosa-pharm tx?
none, unless comorbid psychiatric dis like depression or OCD
tx of bulimia nervosa
SSRI and topiramate
neuroleptics are
typical antipsychotics
mirtazapine MOA
central alpha 2 adrenergic antagonist, antag of 5HT2 and 5HT3 receptors and H1 receptors
cardiovascular effects of TCAs
quinidine-like effect slowing cardiac conduction
why is haloperidol given most frequently for agitation in delirium?
most potent of the typical antipsychotics, therefore requiring lower doses with fewer anticholinergic or orthostatic side effects
risperidone is available
not in IM or IV form, so can’t be given for delirium
