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Hunts BD > Treatments > Flashcards

Treatments Flashcards

1
Q

CAGE-AID

A

for alcohol
2+ yes to in depth assessment

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2
Q

other screening tools for alcohol

A

audit, dast, niad

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3
Q

alcohol withdrawl tx acuute

A
  • BZDs is mainstay
  • medium to long acting ones like diazepam or lorazepam
  • clonidine or atenolol
  • B vitamins
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4
Q

How do you assess alcohol withdraw and when to treat

A

CIWA scoring to assess severity. 8 to 10

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5
Q

how to treat levels of CIWA

A

mild is outpatient, moderate to severe is inpatient
mild is taper BZD and higher is regular BZD

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6
Q

Tx chronic alcohol use - what three medications

A

Thiamine, Naltrexone, Acamprosate

chronically TAN. think: alcoholics have tan/yellow skin

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7
Q

Psychosocial treatment for chronic alcohol use

A

motivational interviewing, CBT

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8
Q

Tobacco use tx

A

1st line recommended combo of long acting and short acting (oral)
or 1st line bupropion
or 1st line Varenicline

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9
Q

acute Opiod use withdrawl tx

A

-Methadone +/- Buphrenorphine
Adjunct clonidine or lofexidine

1) meth head who found a friend
+ apples

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10
Q

What symptoms does someone with opiate use have to have in order to treat their withdrawl

A

pupil dilation (mydriasis), piloerection, hot and cold flashes, general aches, tremor, anorexia

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11
Q

Opiate use withdrawl tx chronic

A

naltrexone, +/-methadone, buphrenorphine

meth head going up a trail with their friend
meth head only goes if they had 1 year of use, or 2 years on meth going back, or preg, or jail

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12
Q

Amphetamine related disorder treament for intoxication

A

IV BZDs for sedation
intubate, antihypertensives, hypertherma give cooling blankets, fluid resuscitation

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13
Q

Chronic use tx for amphetamines

A

Buproprion and Naltrexone 1st line
-Mirtazapine second line

imagery: lost the tv show

plane crash survivors walking through woods

2 days lader tazman devil tries to kill them like on lost

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14
Q

Anxiolytic disorder tx OD

A

flumazenil and long acting BZD for seizures tremors.

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15
Q

Anxiolytic use disorder chornic tx

A

Gradual taper of BZD, use long acting BZD, and use anticonvulsants to reduce craving

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16
Q

Cocaine use tx acute

A

DA antagonist bromocryptine
+ antipsychotic

psychotic bromine

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17
Q

Cocaine use long term tx

A
  • Topiramate 1st line
  • A DA agonist like destramphetatmine, methamphetamine, or modafinil
  • Disulfiram

pirate holding two eggs plus snow + amphetamine

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18
Q

Cannabis use disorder tx

A

psychosocial interventions - CBT, motivational interviewing, peer support
Psychosocial > meds

-hot shower if N/V/D and abd pain

meds can be - gabapentin, topiramate, verencycline, acetylcysteine

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19
Q

PDD

persistent depressive disorder

A

first line SSRI
second line TCA, MAOI

20
Q

Seasonal Affective disorder

A

Light therapy +SSRI

21
Q

Bipolar disorder acute mania

A

For acute manic or hypomanic s/s:

.1.) evaluate inpt vs outpt (severe vs mod)

2.) Severe → antipsychotic + lithium or valproate 3.)

Mild-mod: monotherapy w/ antimanic drug (lithium, antipsychotic, anticonvulsant)

Consider other tx → BZDs (acute agitation), psychotherapy, ECT (refractory)

22
Q

Acute depression BP

A

1.) outpt vs inpt
2.) Avoid antidepres monotherapy and
3.) start on anticonvulsant, lithium or antipsychotic from list below
Other tx → adjunct antidepressants, therapy, ECT (refractory)

closeted health inspect / gun

Anticonvulsants - carbamazepine, valproate , lamotrigine
Lithium (few weeks latency)
Antipsychotics - lurasidone, quetiapine, olanzapine, others

23
Q

Antimanic drugs

A

Lithium (5-10d latency)

Anticonvulsants - carbamazepine, valpoate/valproic acid, divalproex sodium, Lamotrigine/Lamictal prevents mania

Antipsychotics - Quetiapine, lurasidone, risperidone

24
Q

Bioplar Maintenance

A

1.) Preferred - psychotherapy + pharma
2.) 1st line - same med that managed acute
3.) 2nd line - Lithium or quetiapine (Seroquel), valoproate (Depakene), lamotrigine (Lamictal)
4.) 3rd line - other antipsychotics, combo tx
Potentially problematic - antidepressants, BZDs

25
Q

Questionaire for bipolar

A

all of MDD + MDQ
MDQ is all mania and hypomania quesitons

26
Q

Antipsychotics

A

Antipsychotics: quetiapine, lurasidone
- aripiprazole, cariprazin, risperidone, ziprasidone , olanzapine

27
Q

Cyclothymia

A

mood stabiliizers - lithium

29
Q

What are mood stabilizers

A

Valproate (Depakene) / Divalproex (Depakote)
Lamotrigine (Lamictal)
Carbamazepine (Tegretol)

30
Q

Panic Disorder

A

1st line SSRI, paroxetine
2nd line SNRI, TCA
adjunt Benzo, lorazepam

31
Q

Agoraphobia

32
Q

Social anxiety disorder

A

SSRI/SNRI, PRN benzo

33
Q

Social anxiety subtype performance

A

benzos or propanolol prn

34
Q

acute stress disorder

A

CBT, benzo prn, maybe antidepressant

35
Q

PTSD

A

CBT + SSRI/SNRI
refractory = atypical
insomnia = prazosin
agitation = benzo

36
Q

OCD

A

SSRI high dose
2nd line SNRI

37
Q

Phobia

A

1st - CBT w/ exposure therapy
2nd line = PRN benzo if infrequent
2nd line SSRI/SNRI if frequent

38
Q

Depersonalization/Derealization

39
Q

DID

A

SSRI, TCA, MAOI, antipsychotic

40
Q

Klepto

A

SSRI, lithium

41
Q

Pyromania

A

Early intervention programs

42
Q

Gambling

A

SSRI, opiate antagonists

43
Q

Trichtillomania

A

clomipramine

44
Q

Intermittent explosive disorder

A

1st line SSRI
trazodone, buspirone
anticonvulsant/ mood stabilizer

Anticonvulsants/mood stabilizers - lithium, carbamazepine, valproate/divalproex, phenytoin, gabapentin may be helpful

45
Q

Conduct disorder

A

combo of Atypical antipsychotics - risperidone + SSRI + anticonvulsant

Hunts BD (10 decks)

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