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Flashcards in 9 Deck (18)
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1

common length of depressive episode

8-18 mo

2

SSRIs during pregnancy

class C

slight increase in miscarriage, early delivery, autism

paroxetine --> craniofacial abnl

3

mirtazapine MOA

5HT2 and 3 antagonist

4

trazodone MOA

5H2 antagonist reuptake inhibitor

5

melancholic depression criteria

A. During worst of the depression either loss of all
pleasure or lack of reactivity to usually pleasant things

B. 3 or more of the following:
– Distinct quality of depressed mood
– Depression worse in the am
– Early am awakening ( 2hours before normal)
– Marked psychomotor agitation or retardation
– Significant weight loss
– Excessive or inappropriate guilt

6

major neurocognitive disorder criteria

A. Evidence of significant cognitive decline (complex attention, executive function, learning and memory,
language, perceptual‐motor, or social cognition) :
1. Concern of the individual, a knowledgeable informant, or the clinician
2. documented by neuropsychological testing or another
B. interfere with independence in everyday activities
C. do not occur exclusively in the context of a delirium.
D. not better explained by another mental disorder

7

what stays the same cogntiviely with age?

Vocabulary, language ability, reading comprehension, fund of knowledge, IQ
social deportment, political and religious beliefs

8

unhealthy alcohol use for men vs women

men:
More than 14 standard drinks per week on average
More than 4 drinks on any day

women:
More than 7 standard drinks per week on average
More than 3 drinks on any day

9

substance use disorder criteria

2 or more for 12 months:
-Often taken in larger amounts or over a longer period than was intended
• A persistent desire or unsuccessful efforts to cut down or control use
• A great deal of time is spent in activities necessary to obtain, use, or recover from the substance’s effects
• Craving or a strong desire or urge to use the substance
• Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home
-Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by its effects
• Important social, occupational, or recreational activities are given up or reduced because of use
• Recurrent use in situations in which it is physically hazardous
• Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
• Tolerance
• Withdrawal

10

how many criteria to be mild, mod, or severe

• Mild – Two to three criteria
• Moderate – Four to five criteria
• Severe – Six or more criteria

11

CAGE questions

-Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you ever felt bad or Guilty about your drinking?
• Have you ever taken a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?

12

taper off opioids how much per week

A taper of <25% dose reduction per week will minimize withdrawal symptoms

13

delirium tremens

1 wk after etoh withdrawal, preceded by seizures

autonomic withdrawal (tachy, swat, fever, hypotension)
insomnia
hallucinations- assaultive, suicidal
psychomotor activity

14

meds to treat DTs

benzos to prevent seizures

propranolol for autonimic symotoms

clonidine to reduce BP, tremor, HR

15

whats most potent form of crack cocaine

smoking

16

buprenorphine MOA

partial agonist at mu receptor

antagonist of Kappa receptor

17

pharmokinetics of buprenorphine

onset- 30-60 min
peak clinical effects: 1-4 hours, up to 3 days duration
half life: 24-36 hrs

18

clonidine for opioid withdrawal treatment

reduces N/V, diarrhea, cramps, sweating