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Treatments Flashcards

1
Q

Treatment for atypical depression?

A
  1. SSRI
  2. SSRI
  3. MAOi (phenylzine or tranylcypromine)
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2
Q

Adverse effects of Clozapine

A

agranulocytosis, myocarditis, seizures, NMS

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3
Q

What drug can cause myocarditis?

A

Clozapine

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4
Q

What drugs can cause akathisia?

A

Typical antipsychotics
SSRIs
Risperidone
Aripiprazole

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5
Q

how long should wash out be between seritonergic drugs

A

2 weeks

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6
Q

What foods have tyramine

A

wine (more than 1 glass), aged cheese, fava beans, cured meats

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7
Q

What causes hypertensive crisis aside from tyramine rich foods?

A

sympathomimetics like pseudoephedrine

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8
Q

How is HTN crisis treated?

A

phentolamine or IV nitropruside (diastolic >120)

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9
Q

Sx of lithium toxicity?

A

seizure, delirium, stupor, coma

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10
Q

how does lithium cause leukocytosis?

A

2/2 granulocyte demargination

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11
Q

what are 2 medical side effects of valproic acid

A

hepatotoxicity (check LFTs)

pancreatitis (black box warning)

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12
Q

EPS sx in what dopamine pathway?

A

nigrostriatal ~ substantia nigra, degenerates in PD

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13
Q

Pos sx in schizophrenia what dopamine pathway?

A

mesolimbic

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14
Q

Neg sx in schizophrenia what dopamine pathway?

A

mesocortical

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15
Q

Hyperprolactinemia in what dopamine pathway?

A

tuberoinfundibular (DA inhibits prolactin at the pituitary aka infundibulum)

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16
Q

what atypical can cause QTC prolongation?

A

Ziprasidone (Geodon)

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17
Q

Treatment for ADHD

A

stimulants: methylphenidate or amphetamine analogs, atomoxetine (NE reuptake inhibitor), or guanfacine (a2 agonist)

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18
Q

Tourette’s tx

A

antipsychotics (haldol, pimizole), then clonidine/guanfacine

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19
Q

HIV dementia sx

A

memory loss and motor sx

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20
Q

L frontal lobe lesion–> ?

A

depression

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21
Q

R frontal lobe lesion –> ?

A

mania/hypomania

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22
Q

GAD tx

A
  1. SSRIs (escitalopram)

2. Buspirone

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23
Q

OCD tx

A
  1. SSRIs (fluvoxamine, also pralidoxamine?)

2. Clomipramine (TCA)

24
Q

Prazosin use?

A

PTSD-related nightmares

25
Buproprion mechanism
NE/DA reuptake inhibitor
26
Mirtazapine mechanism
NE/5HT antagonists
27
5-HIAA is low in who?
pts who commit suicide
28
Dx carcinoid?
serum 5-HIAA
29
prolactin used how?
differentiate seizure vs. pseudoseizure
30
NPH has opening pressure above what?
20
31
5:2:1/50 cocktail for agitation
5 haldol 2 lorazepam 1 of benztropine or 50 benadryl
32
what substance causes the most deaths?
nicotine
33
1st line MDD
mild/mod--> psychotherapy severe--> Rx *most effective tx is ECT
34
1st line bipolar with mania/mixed episode
lithium/valproic acid or antipsychotic
35
1st line bipolar with major depressive episode
lithium or lamotrigine
36
1st line bipolar with rapid cycling
valproic acid or lithium (VPA preferred)
37
Schizophrenia
antipsychotic, tailor side effects to patients, so ziprasidone/aripiprazole for overweight patients)
38
catatonia tx
lorazepam (ativan)
39
Panic disorder tx
SSRI and benzo, taper benzo after a month
40
PTSD
SSRIs (fluoxetine or sertraline)
41
GAD time period
6 months
42
delusional d/o
1 month
43
cyclothymic or dysthymic
2yrs adults, 1 yr kids
44
post partum blues time course
sx peak 5 days post partum, resolve within 2 weeks
45
post partum psychosis mgmt?
treat immediately
46
premenstrual disorder
severe PMS, dx as depressive disorder NOS, give SSRIs only during luteal phase
47
Paroxetine effect on fetus
persistent pulm htn and fussy babies
48
premature ejaculation tx
SSRI
49
Restless leg tx
1. Iron if deficient | 2. Pramipexole or ropinirole (assoc with new onset gambling and sleep attacks)
50
Night terror tx
long term benzos
51
Narcolepsy assoc REM features
decreased REM latency (60 min into sleep, nml is 90 mins)
52
Specific phobia tx
1. CBT and desensitization | 2. Benzos and B-blockers for autonomic sx
53
social phobia tx
1. SSRIs and CBT | 2. Benzos and B-blockers for performance anxiety
54
What drug is LESS sedating at higher doses?
Mirtazapine
55
Mechanism of Buspirone
partial 5-HT agonist

Psychiatry (2 decks)

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