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Psychiatry > Treatments > Flashcards

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
Q

Buproprion mechanism

A

NE/DA reuptake inhibitor

26
Q

Mirtazapine mechanism

A

NE/5HT antagonists

27
Q

5-HIAA is low in who?

A

pts who commit suicide

28
Q

Dx carcinoid?

A

serum 5-HIAA

29
Q

prolactin used how?

A

differentiate seizure vs. pseudoseizure

30
Q

NPH has opening pressure above what?

A

20

31
Q

5:2:1/50 cocktail for agitation

A

5 haldol
2 lorazepam
1 of benztropine or 50 benadryl

32
Q

what substance causes the most deaths?

A

nicotine

33
Q

1st line MDD

A

mild/mod–> psychotherapy
severe–> Rx
*most effective tx is ECT

34
Q

1st line bipolar with mania/mixed episode

A

lithium/valproic acid or antipsychotic

35
Q

1st line bipolar with major depressive episode

A

lithium or lamotrigine

36
Q

1st line bipolar with rapid cycling

A

valproic acid or lithium (VPA preferred)

37
Q

Schizophrenia

A

antipsychotic, tailor side effects to patients, so ziprasidone/aripiprazole for overweight patients)

38
Q

catatonia tx

A

lorazepam (ativan)

39
Q

Panic disorder tx

A

SSRI and benzo, taper benzo after a month

40
Q

PTSD

A

SSRIs (fluoxetine or sertraline)

41
Q

GAD time period

A

6 months

42
Q

delusional d/o

A

1 month

43
Q

cyclothymic or dysthymic

A

2yrs adults, 1 yr kids

44
Q

post partum blues time course

A

sx peak 5 days post partum, resolve within 2 weeks

45
Q

post partum psychosis mgmt?

A

treat immediately

46
Q

premenstrual disorder

A

severe PMS, dx as depressive disorder NOS, give SSRIs only during luteal phase

47
Q

Paroxetine effect on fetus

A

persistent pulm htn and fussy babies

48
Q

premature ejaculation tx

A

SSRI

49
Q

Restless leg tx

A
  1. Iron if deficient

2. Pramipexole or ropinirole (assoc with new onset gambling and sleep attacks)

50
Q

Night terror tx

A

long term benzos

51
Q

Narcolepsy assoc REM features

A

decreased REM latency (60 min into sleep, nml is 90 mins)

52
Q

Specific phobia tx

A
  1. CBT and desensitization

2. Benzos and B-blockers for autonomic sx

53
Q

social phobia tx

A
  1. SSRIs and CBT

2. Benzos and B-blockers for performance anxiety

54
Q

What drug is LESS sedating at higher doses?

A

Mirtazapine

55
Q

Mechanism of Buspirone

A

partial 5-HT agonist

Psychiatry (2 decks)

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