treatments Flashcards
1
Q
Tx for generalized anxiety disorder
(main treatments= Busy Parties Escalate)
A
- SSRIs- Paroxetine and escitalopram
- SNRIs: Venlafaxine
- Buspirone (take >2wks)
- Benzos
- BBs
- Psychotherapy
2
Q
Tx for panic disorder
(SPF)
A
- SSRIs: Paroxetine, Sertraline, Fluoxetine
- Benzos
- CBT
3
Q
1st line tx for phobias?
A
Exposure therapy
(teach to relax and try to understand/overcome fear)
4
Q
Treatments for phobias
A
- 1st line= Exposure therapy
- SSRI + CBT
- SSRI= paroxetine, escitalopram
- Benzos (i.e. prior to flying)
5
Q
Tx for acute mania in bipolar I
A
- Lithium
- Valproate
- SGAs (Olanzapine, aripiprazole)
- carbamazepine
6
Q
Tx for mania maintenance in Bipolar I (3)
A
SGAs
Gabapentin
Lamotrigine
7
Q
What group of meds should you add in bipolar I if there is agitation?
A
antipsychotics (haloperidol, risperidone)
Benzos
8
Q
What group of meds should be avoided in patients with bipolar I
A
SSRIs
9
Q
First line medication for bipolar disorder
A
lithium
10
Q
Tx for depressive episodes in bipolar II (3 options)
A
- SSRIs
- quetiapine
- olanzapine + fluoxetine
11
Q
tx for cyclothymia
A
- Lithium
- Anticonvulsant meds
- valproate
- carbamazepine
12
Q
1st line tx for major depressive disorder
A
SSRIs
(increase dose q3-4weeks until sx remission)
13
Q
treatment for persistent depressive disorder (dysthymia)
A
- SSRIs and other antidepressants
- psychotherapy
- physical exercise
14
Q
tx for conduct disorder
A
- 1st line= behavioral therapy (including parent management training)
- tx for sxs of aggression and agitation
- alpha agonists
- mood stabilizers
- BB
- antipsychotics
15
Q
Tx for Bulemia nervosa
A
Fluoxetine
(higher dose than used in depression. Helps break binge-pure cycle)
16
Q
Tx for binge eating disorder
A
Psychotherapy
- self-help treatment
- pharmacotherapy
- behavioral weight loss treatment
17
Q
tx for anorexia nervosa
A
- Restore nutritional state
- Hospitalization if weight <75% expected body weight
- behavioral therapy
- +/- SSRIs
18
Q
at what point does a patient with anorexia nervosa require hospitalization
A
if weight <75% expected body weight
19
Q
tx for OCD
A
- Psychotherapy (CBT)
- SSRIs (12-16wk trial, higher dose than for depression)
- Clomipramine
- Augment w/ antipsychotics
20
Q
Tx for body dysmorphic disorder
A
1st line- SSRIs
Psychotherapy (CBT)
21
Q
tx for hoarding disorder
A
High dose SSRIs (Paroxetine) w/ CBT
Paroxetine= FDA indication for hoarding
22
Q
Tx for trichotillomania (hair pulling disorder)
A
- CBT= 1st line
- hypnosis, relaxation techniques and substitution w/ another behavior
- SSRIs, TCAs, antipsychotics, lithium
23
Q
Tx for excoriation disorder
A
CBT and SSRI (fluoxetine)
24
Q
Tx for ADHD (4)
A
- First line (wt. loss & decr. growth)
- Methylphenidate (Ritalin, Concerta, Daytrana)
- Dexmethylphenidate (Focalin)
- Amphetamine/detroamphetamine (Adderall, Dexedrine)
- Atomoxetine (Strattera) selective norepinephrine reuptake inhibitor (non-stimulant)
- 2nd line/adjuncts
- antidepressants (guanfacine, clonidine, imipramine, bupropion, venlafaxine
- behavior modifcation, family, educational management
25
Tx for autism- (4 + 2 groups of meds)
* Refer- **autism specialists**, speech and language pathologist
* Audiology eval, +/- EEG
* Behavioral therapy
* Meds
* **Second gen antipsychotics** (risperidone, aripiprazole); haloperidol, carbamazepine
* **SSRIs**
26
Tx for delusional disorder
* psychotherapy
* Atypical antipsychotics **(olanzapine and risperidone**, later said aripiprazole or ziprasidone)
27
tx for schizoaffective disorder
* psychotherapy
* **atypical antipsychotics**
* anticonvulsants
* SSRIs
28
Schizophrenia:
Tx for negative sxs
* Atypical anyipsychotics
* risperidone
* olanzapine
* aripiprazole
* ziprasidone
* quetiapine
* asenapine
* paliperidone
* Clozapine- NOT 1st line b/c agranulocytosis
29
Schizophrenia:
Tx for positive sxs
* Typical neuroleptics
* haloperidol
* chlorpromazine
* thioridazine
* loxapine
* fluphenazine
30
How do you tx resistant cases of schizophrenia?
Clozapine or antipsychotic + another med (benzo, carbamazepine, valproate, lithium)
31
tx for schizoaffective disorder
* psychotherapy
* **atypical antipsychotic** (drug of choice)
* resistant: atypical antipsychotic + lithium or anticonvulsant or switch to typical antipsychotic
32
tx for somatization disorder
* Single clinician as PCP
* monthlly visits and psychotherapy
* avoid unneccessary diagnostic testing
33
tx for illness anxiety disorder (hypochondriasis)
* Group/insight-oriented therapy
* regular appts w/ a provider for reassurance
* **_SSRIs_**
34
tx for alcohol withdrawal (5)
**thiamine**
magnesium
multivitamin
dextrose
**benzos**
35
First line tx for PTSD
SSRI or SNRI
+
Trauma-focused CBT (exposure therapy, cognitive therapy and various combos of these modalities)
36
What is psychodynamic psychotherapy
Focuses on improving **ego strength** and **capacity of interpersonal relatedness**
37
First line tx for exhibitionistic disorder (and other paraphilias)
(flashers, exposing genitals)
**psychotherapy**
((may involve CBT, social skills training and group therapy)
38
pharmacotherapy for exhibitionist disorder (flasher)
* **_antiandrogens_**
* long-acting gonadotropin-releasing hormones
* **_SSRIs_**
* naltrexone
39
First line tx for newly diagnosed specific phobia in adults
CBT w/ exposure to the phobic stimulus
40
What is the drug of choice for benzo withdrawal to decrease the severity of withdrawal sxs?
long acting barbiturates- **phenobarbital**
41
tx for benzo withdrawal w/ MILD sxs
**_diazepam w/ taper_**
(severe sxs= hypotension, severe psychomotor agitation, disorientation, hallucinations)
42
Tx for sexual masochism disorder(7)
1. **CBT**
2. **SSRIs**
3. lithium
4. mood stabilizers
5. **anti-androgens,**
6. phenothizines
7. long acting gonadotropin-releasing hormones
43
What questionare is used to determine goals for therapy and level of therapist-patient bond in patients with obsessive compulsive personality disorder
Working Alliance Inventory
44
Pharmacologic tx for conduct disorder (adjunct to counseling)
stimulants:
**_methylphenidate, dextroamphetamine_**
(antidepressants and lithium may also be helpful)
45
How do you treat the EPS symptom akathisia (restlessness) seen in patients taking antipsychotics? (3)
1. BB
2. Benztropine
3. Benzos
46
What are the 3 **psychotherapy** options may be effective when treating **illness anxiety disorder**
Relaxation training
problem-solving trainging
behavioral stress management
47
First line tx for males with pedophilic disorder
**_Medroxyprogesterone IM_**
(decreases libido by blocking testosterone synthesis)
Could also use leuprolide but this is $$$
48
What med should be given with haloperidol to reduce the risk of severe extrapyramidal sxs including dystonias?
diphenhydramine or benztropine
49
Treatment for delusional disorder
first goal= establish a therapeutic alliance with the patient
1st line meds: antipsychotics (ex: aripiprazole)
50
Which antidepressant does not commonly cause sexual dysfunction?
Bupropion
51
Which agent (2) may be added to cognitive-behavioral therapy and serotonergic antidepressants when only a partial response is obtained in a patient with generalized anxiety disorder?
Buspirone or pregabalin.
52
Tx for PTSD (ROsh)
CBT + one or more of the following:
serotinergic antidepressents
second gen antipsychotics
alpha adrenergic receptor blockers
53
What med is contraindicated in Bulimia nervosa
Bupropion (due to risk of seizures)
54
What is the best medication to use in patients with **conduct disorder** who are experiencing **worsening symptoms despite behavioral and psychologic intervention.**
methylphenidate
55
What are the only 2 psychotropic medications approved by the FDA for treatment of autism spectrum disorder ina child or adolescent
Risperidone
aripiprazole
56
What medication is recommended for patients with debilitating anxiety related to performance situations?
Propanolol
57
1st line pharmacotherapy for body dysmorphic disorder
fluoxetine
(if no response, titrate, augment with clomipramie or change to different SSRI)-- if add climpramine, monitor for seritonin syndrome
58
In addition to supportive treatment, which 2 medications are most commonly used for tx of **_neuropleptic malignant syndrome_**?
dantrolene
bromocriptine
59
What med can be used to treat bipolar disorder and schizophrenia but is also used in **anorexia nervosa to cause weight gain**
olanzapine
60
1st line tx for anxiety disorder
Venlafaxine
61
How do you treat a patient with autism who also has anxiety symptoms?
SSRI (e.g. Sertraline or fluoxetine)
62
What pharmacotherapy can be used in BPD to treat anger management and mood stability?
Lamotrigine and topiramate
63
Tx for TCA (ex: amitriptyline) toxicity? specifically ventricular dysrhythmias or hypotension
sodium bicarb
(drug of choice for tx of ventricular dysrhythmias or hypotension)
64
Tx for TCA associated seizures (3)?
tx aggressively to avoid cardiotoxicity---\>
Benzos
phenobarbital
intubation
65
Tx for overdose with Isoniazid (TB med)
pyridoxine
66
Tx for **irritability, aggression** or deliberate **self-injury** in children with **autism**
risperidone
67
What can be used to tx mood swings in patients with narcissistic personality disorder
lithium
68
3 treatments for serotonin syndrome
mild to moderate cases- cessation of offending agents, benzos, IVF and obs
1. benzos
2. hydration/cooling
3. cyproheptadine
69
tx of OCD in children
CBT
Fluoxetine, fluvoxamine, sertraline (maybe citalopram?)
70
T/F is paroxetine approved as tx for pediatric populations
false
71
Dialectal behavioral therapy is used for tx of what
Borderline personality disorder
