10 Flashcards

(14 cards)

1
Q

buspirone MOA

A

MOA: 5HT1A agonist

Good for GAD but takes 4-6 week for effect

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2
Q

mirtazepine MOAs

A

*Alpha2 blockade and NaSSA
 5HT1A agonist: antidepressant/anxiolytic benefit
 5HT2A antagonist: sleep
 5HT2C antagonist: wt gain
 H1 antag: sedation, wt gain, anxiolytic
 Less antihistamine and more NE effect at higher doses

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3
Q

trazodone MOA

A

Inhibits presynaptic 5HT reuptake and blocks postsynaptic 5HT2

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4
Q

valproate Rx

A

Acute Mania, mixed mania (Better with Rapid cycling and dysphoric mania)
epilepsy
migraine prophalyxis

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5
Q

carbamazepine Rx

A

Acute mania, maintenance, rapid cycling, mixed episodes

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6
Q

creutzfeld-jacob

A

Rapidly progressive dementia

Often with movement disorder (Parkinsonism, cerebellar signs)

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7
Q

non-pharm treatments of delirium

A
  • Orientation techniques
  • Familiarizing patient with environment
  • Natural lighting and diurnal cues
  • Avoid restraints
  • Caregiver support and education
  • Reduce/discontinue unnecessary medications, opiates, anticholinergics, benzos
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8
Q

pharm treatments of delirum

A
  • antipsychotics- *haldol, atypicals (TBI)
  • benzos (etoh withdrawal)
  • anticonvulsants (ictal)
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9
Q

delirium symptoms

A
  • Background slowing on EEG
  • Sleep-wake disturbance
  • psych: hallucinations, delusions, affect lability, anxiety
  • Movement alterations: hyperactive or hypo or mixed
  • cognitive: attention, memory deficits, disoriented

FLUCTUATES, ACUTE

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10
Q

Confusion Assessment Method (CAM)

A
1. History of acute onset of change in patient’s normal mental status & fluctuating course?
AND
2.Lack of attention? AND EITHER
3. Disorganized thinking?
4. Altered Level of Consciousness
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11
Q

delirium differential

A

VITAMINS

Vascular
Infectious
Toxic (OD, withdrawal)
Trauma (concussion)
Autoimmune
Metabolic (electrolytes, liver)
Iatrogenic
Neoplasms
Seizures
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12
Q

iatrogenic causes of delirum

A
Restraints
 Urinary catheters
 Multiple procedures
 Sleep deprivation
 Untreated pain
 Variety of medications(refer to handout)  Surgery
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13
Q

Best established neurotransmitter dysfunction in delirium

A

reduced cholinergic activity

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14
Q

MMSE interpretation of score

A

A score of less than 24 points is suggestive of dementia or delirium

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