psych 2 Flashcards
anorexia effects (physiological, in blood etc, inv)
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
Features
reduced body mass index
bradycardia
hypotension
enlarged salivary glands
Physiological abnormalities
hypokalaemia
low FSH, LH, oestrogens and testosterone
raised cortisol and growth hormone
impaired glucose tolerance
hypercholesterolaemia
hypercarotinaemia
low T3
lithium follow up
- therapeutic window , taken when
- s/e
- complications
(0.4-1.0 mmol/L) - taken 12 post-dose, weekly after dose change until stable, then every 3m for a year, then 6m
S/E
- n/v/d
- fine tremor
- polyuria
- weight gain
serious
- hypothyroidism (low mood, reduced appetite …)
- intracranial HTN
- nephrotoxicity - neph diabetes insipidus (polyuria)
- leucocytosis (fine if asympt)
- hyperPTH - hyperCa
- ECG: T wave flattening/inversion
- so check TFT, ECG, U/E, FBC,
thyroid and renal every 6m longterm
clomipramine
=?
used for?
side effects
Tricyclic antidepressant
OCD/ panic/ depression/ chronic pain
anticholinergic
- dry mouth
- blurred vision
- urinary retention
- Mydriasis (big pupil, small = miosis)
- constipation
- vom
- lengthened QT interval
antihistaminic
- weight gain
- drowsy
triptans and SSRI
no
(triptans abort migraines (not prevent))
brief psychotic disorder
psychosis lasting <1m
previous lithium toxicity …
can’t take lithium again!
clanging = ?
rhyming words together (stool pool) rather than speaking based on word meaning
schiz
hypnagogic halluc
Hypnopompic halluc
fall asleep
waking up
these are pseudo hallucinations (insight! , know not real (Acording to some definitions, others say that it is when voice inside head)
b blocker overdose antidote
atropine
IV glucagon - reverses hypoglycaemia, and improves myocardial contractility and heart rate
tardive dyskinesia treated by what
tetrabenazine
(tardive dyskinesia caused by antipsych)
acute dystonia treated by what
Procyclidine and benztropine
(anticholinergic)
(also for PD)
first line SSRi
- in adults
- breast feeding
- in paeds
sertraline
sertraline or paroxetine
fluoxetine (fluoxeteen) - needs follow up as particularly increases suicidal ideation at first, esp in young people
SSRI discontinuation syndrome
- symptoms
- esp likely if… ?
GI - diarhea/ vom/ abdo pain
mood change, restless - anxiety
sleep issues
unsteady - dizzy
sweaty
paraesthesia - electric shock
esp if take MAOi
benzo overdose symptoms
excessive sedation, including somnolence, diplopia, impaired motor function, anterograde amnesia, ataxia, hypoxaemia, hypothermia, hypotension and bradycardia.
serotonin syndrome
- causes
- symtpoms
- treatment
- monoamine oxidase inhibitors
- SSRIs
— St John’s Wort, often taken over the counter for depression, can interact with SSRIs to cause serotonin syndrome - ecstasy
- amphetamines
(1) neuromuscular excitation (myoclonus and hyperreflexia)
(2) autonomic nervous system excitation (fever and sweating)
(3) altered mental state (confusion and agitation)
IV fluids
benzos
cyproheptadine and chlorpromazine (Serotonin antagonists if severe)
