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MJ- Mental Health EOR > treatments > Flashcards

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
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2
Q

Tx for panic disorder

(SPF)

A
  • SSRIs: Paroxetine, Sertraline, Fluoxetine
  • Benzos
  • CBT
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3
Q

1st line tx for phobias?

A

Exposure therapy

(teach to relax and try to understand/overcome fear)

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4
Q

Treatments for phobias

A
  • 1st line= Exposure therapy
  • SSRI + CBT
    • SSRI= paroxetine, escitalopram
  • Benzos (i.e. prior to flying)
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5
Q

Tx for acute mania in bipolar I

A
  • Lithium
  • Valproate
  • SGAs (Olanzapine, aripiprazole)
  • carbamazepine
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6
Q

Tx for mania maintenance in Bipolar I (3)

A

SGAs

Gabapentin

Lamotrigine

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7
Q

What group of meds should you add in bipolar I if there is agitation?

A

antipsychotics (haloperidol, risperidone)

Benzos

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8
Q

What group of meds should be avoided in patients with bipolar I

A

SSRIs

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9
Q

First line medication for bipolar disorder

A

lithium

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10
Q

Tx for depressive episodes in bipolar II (3 options)

A
  • SSRIs
  • quetiapine
  • olanzapine + fluoxetine
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11
Q

tx for cyclothymia

A
  • Lithium
  • Anticonvulsant meds
    • valproate
    • carbamazepine
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12
Q

1st line tx for major depressive disorder

A

SSRIs

(increase dose q3-4weeks until sx remission)

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13
Q

treatment for persistent depressive disorder (dysthymia)

A
  • SSRIs and other antidepressants
  • psychotherapy
  • physical exercise
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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
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15
Q

Tx for Bulemia nervosa

A

Fluoxetine

(higher dose than used in depression. Helps break binge-pure cycle)

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16
Q

Tx for binge eating disorder

A

Psychotherapy

  • self-help treatment
  • pharmacotherapy
  • behavioral weight loss treatment
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17
Q

tx for anorexia nervosa

A
  • Restore nutritional state
  • Hospitalization if weight <75% expected body weight
  • behavioral therapy
  • +/- SSRIs
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18
Q

at what point does a patient with anorexia nervosa require hospitalization

A

if weight <75% expected body weight

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19
Q

tx for OCD

A
  • Psychotherapy (CBT)
  • SSRIs (12-16wk trial, higher dose than for depression)
  • Clomipramine
  • Augment w/ antipsychotics
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20
Q

Tx for body dysmorphic disorder

A

1st line- SSRIs

Psychotherapy (CBT)

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21
Q

tx for hoarding disorder

A

High dose SSRIs (Paroxetine) w/ CBT

Paroxetine= FDA indication for hoarding

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22
Q

Tx for trichotillomania (hair pulling disorder)

A
  • CBT= 1st line
  • hypnosis, relaxation techniques and substitution w/ another behavior
  • SSRIs, TCAs, antipsychotics, lithium
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23
Q

Tx for excoriation disorder

A

CBT and SSRI (fluoxetine)

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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
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25
Q

Tx for autism- (4 + 2 groups of meds)

A
  • Refer- autism specialists, speech and language pathologist
  • Audiology eval, +/- EEG
  • Behavioral therapy
  • Meds
    • Second gen antipsychotics (risperidone, aripiprazole); haloperidol, carbamazepine
    • SSRIs
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26
Q

Tx for delusional disorder

A
  • psychotherapy
  • Atypical antipsychotics (olanzapine and risperidone, later said aripiprazole or ziprasidone)
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27
Q

tx for schizoaffective disorder

A
  • psychotherapy
  • atypical antipsychotics
  • anticonvulsants
  • SSRIs
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28
Q

Schizophrenia:

Tx for negative sxs

A
  • Atypical anyipsychotics
    • risperidone
    • olanzapine
    • aripiprazole
    • ziprasidone
    • quetiapine
    • asenapine
    • paliperidone
  • Clozapine- NOT 1st line b/c agranulocytosis
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29
Q

Schizophrenia:

Tx for positive sxs

A
  • Typical neuroleptics
    • haloperidol
    • chlorpromazine
    • thioridazine
    • loxapine
    • fluphenazine
30
Q

How do you tx resistant cases of schizophrenia?

A

Clozapine or antipsychotic + another med (benzo, carbamazepine, valproate, lithium)

31
Q

tx for schizoaffective disorder

A
  • psychotherapy
  • atypical antipsychotic (drug of choice)
  • resistant: atypical antipsychotic + lithium or anticonvulsant or switch to typical antipsychotic
32
Q

tx for somatization disorder

A
  • Single clinician as PCP
    • monthlly visits and psychotherapy
    • avoid unneccessary diagnostic testing
33
Q

tx for illness anxiety disorder (hypochondriasis)

A
  • Group/insight-oriented therapy
  • regular appts w/ a provider for reassurance
  • SSRIs
34
Q

tx for alcohol withdrawal (5)

A

thiamine

magnesium

multivitamin

dextrose

benzos

35
Q

First line tx for PTSD

A

SSRI or SNRI

+

Trauma-focused CBT (exposure therapy, cognitive therapy and various combos of these modalities)

36
Q

What is psychodynamic psychotherapy

A

Focuses on improving ego strength and capacity of interpersonal relatedness

37
Q

First line tx for exhibitionistic disorder (and other paraphilias)

(flashers, exposing genitals)

A

psychotherapy

((may involve CBT, social skills training and group therapy)

38
Q

pharmacotherapy for exhibitionist disorder (flasher)

A
  • antiandrogens
  • long-acting gonadotropin-releasing hormones
  • SSRIs
  • naltrexone
39
Q

First line tx for newly diagnosed specific phobia in adults

A

CBT w/ exposure to the phobic stimulus

40
Q

What is the drug of choice for benzo withdrawal to decrease the severity of withdrawal sxs?

A

long acting barbiturates- phenobarbital

41
Q

tx for benzo withdrawal w/ MILD sxs

A

diazepam w/ taper

(severe sxs= hypotension, severe psychomotor agitation, disorientation, hallucinations)

42
Q

Tx for sexual masochism disorder(7)

A
  1. CBT
  2. SSRIs
  3. lithium
  4. mood stabilizers
  5. anti-androgens,
  6. phenothizines
  7. long acting gonadotropin-releasing hormones
43
Q

What questionare is used to determine goals for therapy and level of therapist-patient bond in patients with obsessive compulsive personality disorder

A

Working Alliance Inventory

44
Q

Pharmacologic tx for conduct disorder (adjunct to counseling)

A

stimulants:

methylphenidate, dextroamphetamine

(antidepressants and lithium may also be helpful)

45
Q

How do you treat the EPS symptom akathisia (restlessness) seen in patients taking antipsychotics? (3)

A
  1. BB
  2. Benztropine
  3. Benzos
46
Q

What are the 3 psychotherapy options may be effective when treating illness anxiety disorder

A

Relaxation training

problem-solving trainging

behavioral stress management

47
Q

First line tx for males with pedophilic disorder

A

Medroxyprogesterone IM

(decreases libido by blocking testosterone synthesis)

Could also use leuprolide but this is $$$

48
Q

What med should be given with haloperidol to reduce the risk of severe extrapyramidal sxs including dystonias?

A

diphenhydramine or benztropine

49
Q

Treatment for delusional disorder

A

first goal= establish a therapeutic alliance with the patient

1st line meds: antipsychotics (ex: aripiprazole)

50
Q

Which antidepressant does not commonly cause sexual dysfunction?

A

Bupropion

51
Q

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?

A

Buspirone or pregabalin.

52
Q

Tx for PTSD (ROsh)

A

CBT + one or more of the following:

serotinergic antidepressents

second gen antipsychotics

alpha adrenergic receptor blockers

53
Q

What med is contraindicated in Bulimia nervosa

A

Bupropion (due to risk of seizures)

54
Q

What is the best medication to use in patients with conduct disorder who are experiencing worsening symptoms despite behavioral and psychologic intervention.

A

methylphenidate

55
Q

What are the only 2 psychotropic medications approved by the FDA for treatment of autism spectrum disorder ina child or adolescent

A

Risperidone

aripiprazole

56
Q

What medication is recommended for patients with debilitating anxiety related to performance situations?

A

Propanolol

57
Q

1st line pharmacotherapy for body dysmorphic disorder

A

fluoxetine

(if no response, titrate, augment with clomipramie or change to different SSRI)– if add climpramine, monitor for seritonin syndrome

58
Q

In addition to supportive treatment, which 2 medications are most commonly used for tx of neuropleptic malignant syndrome?

A

dantrolene

bromocriptine

59
Q

What med can be used to treat bipolar disorder and schizophrenia but is also used in anorexia nervosa to cause weight gain

A

olanzapine

60
Q

1st line tx for anxiety disorder

A

Venlafaxine

61
Q

How do you treat a patient with autism who also has anxiety symptoms?

A

SSRI (e.g. Sertraline or fluoxetine)

62
Q

What pharmacotherapy can be used in BPD to treat anger management and mood stability?

A

Lamotrigine and topiramate

63
Q

Tx for TCA (ex: amitriptyline) toxicity? specifically ventricular dysrhythmias or hypotension

A

sodium bicarb

(drug of choice for tx of ventricular dysrhythmias or hypotension)

64
Q

Tx for TCA associated seizures (3)?

A

tx aggressively to avoid cardiotoxicity—>

Benzos

phenobarbital

intubation

65
Q

Tx for overdose with Isoniazid (TB med)

A

pyridoxine

66
Q

Tx for irritability, aggression or deliberate self-injury in children with autism

A

risperidone

67
Q

What can be used to tx mood swings in patients with narcissistic personality disorder

A

lithium

68
Q

3 treatments for serotonin syndrome

A

mild to moderate cases- cessation of offending agents, benzos, IVF and obs

  1. benzos
  2. hydration/cooling
  3. cyproheptadine
69
Q

tx of OCD in children

A

CBT

Fluoxetine, fluvoxamine, sertraline (maybe citalopram?)

70
Q

T/F is paroxetine approved as tx for pediatric populations

A

false

71
Q

Dialectal behavioral therapy is used for tx of what

A

Borderline personality disorder

MJ- Mental Health EOR (4 decks)

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