Special drill on med side effects

Question 1

Procainamide, quinidine

Answer 1

confusion, delirium

Question 2

albuterol

Answer 2

anxiety, confusion

Question 3

isoniazid

Answer 3

psychosis

Question 4

tetracycline

Answer 4

depression

Question 5

nifedipine, verapamil

Answer 5

depression

Question 6

cimetidine

Answer 6

depression, confusion, psychosis

Question 7

steroids

Answer 7

aggressiveness/ agitation, mania, depression, anxiety, psychosis

Question 8

ECT as other treatment

Answer 8

premedicate with atropine
general anesthesia
muscle relaxants (succinylcholine)
generalized tonic-clonic seizure then induced, unilateral or bilateral electrodes.
likely anticonvulsant effects, as well as brain perfusion and connectivity changes
MOST EFFECTIVE treatment for major depressive disorder, esp with psychotic features
also for acute mania and catatonia

often for pts who cannot tolerate meds, failed other treatments. Discontinued after symptomatic improvement, 8-12 sessions 3x per week and then monthly maintenance.

side effects: muscle soreness, headaches, amnesia, confusion
bilateral electrodes more efficacious, but increase memory impairment and confusion

Question 9

Deep Brain STimulation treatment

Answer 9

DBS- surgical treatment
implantation of med device –> electrical impulses to specific parts of the brain
in select brain regions - benefits for Parkinson’s disease, disabling dystonia, chronic pain and tremors.
underlying principles/ mechanism still not clear.
directly changes brain activity in a controlled manner, effects are reversible
helpful in some pts, but serious complications and side effects possible

Question 10

Repetitive transcranial magnetic stimulation

Answer 10

rTMS- noninvasive
excite neurons
weak electric currents induced in tissue by rapidly changing magnetic fields
brain activity triggered with minimal discomfort
longer-lasting changes than nonrepetitive stimulation

less efficacy than ECT, price is high

Question 11

Light therapy

Answer 11

exposure to daylight or specific wavelengths of light using lasers, light-emitting diodes, fluorescent lamps, dichroic lamps, or very bright, full-spectrum light
prescribed amount of time, sometimes specific time of day

treat MDD with seasonal pattern, some support for use with nonseasonal psychiatric disorders.