Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
Clinical Guidelines for Prescribing Psychotropic Drugs : The 5 D’s
|
Diagnosis
Careful diagnostic evaluation to identify specific target symptoms Drug selection Choice of drug based on patient factors, etc. Dosage Adequate dosing and trial of medication Duration Adequate duration before assuming failure Dialogue Discuss SE and expectations with patient |
|
|
• Describe psychotropic use in special populations:
children elderly pregnant/nursing medically ill **EXAM** |
***Children***(EXAM)
Begin with small doses and increase until clinical effects are observed ***Elderly*** Start with ½ the usual starting dose and increase slowly **Pregnant and Nursing Women** All psychotropic medications cross the placenta Try to avoid during pregnancy (esp. 1st trimester) or when nursing Consider ECT in severe cases **Medically Ill Persons** Treat using most conservative clinical practice |
|
|
what is Serotonin Syndrome? cause? sx? tx?
|
Cause
Administration of drugs that can raise plasma serotonin concentration ****22% SSRI OD/ MAOI/Tramadol**** Symptoms Nausea, vomiting, diarrhea Restlessness Extreme agitation Confusion Hyperreflexia Autonomic instability Myoclonus, seizures, *** hyperthermia, shivering, rigidity Delirium, coma, CV collapse, death Treatment Stop offending agents Supportive care Control agitation (benzodiazepines) Control autonomic instability Control hyperthermia 5-HT2A antagonists (cyproheptadine, olanzapine) |
|
|
what is Neuroleptic Malignant Syndrome? clinical findings?
|
Cause
Complication of neuroleptic drugs Typicals > Atypicals ****Clozapine + lithium**** Clinical Features Hyperthermia Autonomic instability Extreme muscle rigidity, tremor Mental status change, confusion Dystonia or akinesia Mutism Agitation Leukocytosis ***Elevated CPK*** Coma, death |
|
|
define the following Extra Pyramidal Symptoms:
Parkinsonism Akathisia Dystonia |
Parkinsonism
A movement disorder which mimics the signs & symptoms of idiopathic Parkinson’s disease--give anticholinergic Akathisia A severe form of restlessness associated with a compulsion to move Dystonia Spasms or muscle stiffness usually most prominent in head and neck, which occur early in the course of treatment or with dose increases |
|
|
what is the Most effective treatment for mood disorders, that is used for rapid response. One side effect is potentially forgetting large portions of your life
|
ElectroConvulsive Therapy
Most Common Indications Major depressive disorder Bipolar disorder – depression or mania Refractory schizophrenia Catatonia (in mood disorders or schizophrenia) Mood disorders in pregnancy Relative Contraindications Increased intracranial pressure (NPH, benign intracranial hypertension, etc.) Intracranial lesions (tumor, hematoma, aneurysm, AVM, etc.) Recent myocardial infarction (< 3 months) Recent stroke Unstable aortic aneurysm |
|
|
A collective term for a set of late-onset and sometimes irreversible disorders which can include chorea, dysphonia, dystonia, tics, and myoclonus
|
Tardive Dyskinesia
|
|
|
tx for Depression w/ seasonal pattern
Adjunct in non-seasonal depression Sleep disorders (e.g., shiftwork, jet lag) OCD w/ seasonal pattern |
Phototherapy
|
|
|
A patient presents to the ER with extreme agitation, NVD, hyperreflexia, hyperthermia, shivering, and rigidity. Paramedics found an empty SSRI bottle next to him on the scene.
**EXAM** |
Serotonin Syndrome
(administration of drugs that cause an increase in plasma serotonin concentration) |
|
|
Drugs Most likely to cause serotonin syndrome?
|
22% SSRI OD/ MAOI/Tramadol
|
|
|
What drug combo is most likely to cause Neuroleptic Malignant Syndrome
*** |
Clozapine + lithium
|
|
|
What lab value is pathognomonic for Neuroleptic Malignant syndrome?
*** |
Elevated CPK
|
|
|
What 3 classes of drugs can be used to treat Akathisia (extrapyramidal side effect)?
(Akathisia = restless leg syndrome) |
Anticholinergics
BDZs Beta-Blockers |
|
|
A patient comes in with muscle stiffness, eye fixation, and torticolis. You realize this is an extrapyramidal side effect called Dystonia. What drug can you give to treat?
|
Anticholinergic
|
|
|
What (2) drugs are most likely to cause tardive dysinesia?
*** |
Haloperidol
Risperidone |
|
|
What is the most effective treatment for mood disorders?
**EXAM** |
ELECTROCONCULSIVE THERAPY
Major Depression = 80-90% efficacy Bipolar Mania = 80& efficacy |
|
|
If you have a pregnant patient with a mood disorder, what is the best treatment?
**EXAM** |
Electroconvulsive Therapy
|
|
|
Which psychiatric therapy has NO absolute contraindications? Only relative contraindications.
|
Electroconvulsive Therapy
|
|
|
Which form of Electroconvulsive therapy has less side effects and is less effective?
Nondominant Unilateral VS Bilateral |
Nondominant Unilateral
|
|
|
Which form of Electroconvulsive Therapy has more side efects but is considered more effective?
Nondominant Unilateral VS Bilateral **** |
Bilateral
|
|
|
What is a proposed treatment for refractory OCD?
****** |
Deep Brain Stimulation
|
