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Classification: Flashcards

1
Q

What can most psych disorders be split into?

A
  • Organic (2ndry to physical causes)

- Functional

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2
Q

List 3 causes of organic disorders:

A
  • Cerebral tumours
  • Endocrine disorders
  • Psychoactive substance use disorders
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3
Q

List 2 function disorders:

A
  • Psychoses

- Neuroses

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4
Q

What are 2 other classifications of psych disorders?

A
  • Developmental
  • Behavioural

(e.g. personality disorders, learning disability, eating disorders, psychosexual disorders)

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5
Q

What is ICD-10?

A

For each psych disorder, a description of main clinical features, associated features and diagnostic guidelines are provided.

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6
Q

List 3 types of physical management of psych disorders:

A
  • Pharmacotherapy
  • ECT
  • Phototherapy
  • Psychosurgery
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7
Q

List 2 types of psychological management of psych disorders:

A
  • CBT

- Family therapy

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8
Q

List 2 types of psychosocial management:

A
  • OT

- Rehabilitation

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9
Q

What can hypnotics be used for?

A
  • Treating insomnia
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10
Q

What medications come under hypnotics/for treatment of insomnia?

A
  • Benzodiazapines

- Z- drugs (work in the same way as BZDs)

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11
Q

In what patient group should BZDs and Z-drugs be avoided in?

A

The elderly due to risk of ataxia and confusion falls.

Alternative is melatonin

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12
Q

What are the issues with hypnotics?

A
  • Tolerance develops within 3-14/7 on continuous use
  • Withdrawal can rebound insomnia

(short courses should be used in acutely distressed patients (2-4/52) )

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13
Q

List 3 antianxiety medication classes:

A
  • BZDs
  • Buspirone
  • B blockers
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14
Q

Why are beta blockers used in anxiety?

A

Reduce the autonomic symptoms (tremors, palpatations)

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15
Q

What should be prescribed in chronic anxiety?

A

(>4/52) - may us an antidepressant combined with a BZD until the antidepressant takes effect.

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16
Q

List 2 bendodiazepines:

A
  • Diazepam (long -acting)
  • Temazapam (short-acting)
  • Lorazepam
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17
Q

List 2 beta blockers:

A
  • Bisoprolol
  • propanolol
  • Atenolol
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18
Q

When should be used in panic disorders which are resistant to antidepressives?

A

Lorazepam or clonazepam (BZD)

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19
Q

What regime should BZD be used in?

A
  • Short periods (max. 2-4/52)
  • Lowest dose
  • For severe anxiety
20
Q

In what type of BZD is withdrawal more common?

A

Short acting (such as temazepam)

21
Q

How long does it take for one to develop tolerance to BZD?

22
Q

What should be done to avoid withdrawal symptoms?

A

Reduce BZD regime very slowly

23
Q

What should you advise patients on BZD to not do?

A

Driving - psychomotor impairment is a SE of BZDs.

24
Q

What can be used in BZD overdose and why?

A

Flumazenil (BZD antagonist)

25
What are the side effects of 1) mild/mod BZD overdose and 2) extreme BZD overdose?
1) Intensification of therapy or, paradoxical excitation | 2) Hospital admission required due to: coma, areflexia, cardiorespiratory depression, apnoea
26
List 3 other mediactions that can be used as anxiolytics apart from BZD and Beta-blockers?
- Melatonin (insomnia in >55s) - Z-drugs (non-BZD - Zopiclone) - Buspirone (short-term use in anxiety. does not alleviate BZD withdrawal)
27
List the 5 classes of anti-depressants:
- SSRIs (selective serotonin re-uptake Inhibitor) - TCAs (Tricyclic anti-depressants) - SNRIs (serotonin and noradrenaline re-uptake inhibitor) - NaSSA (Noradrenaline and specific serotonergic AD) - MAOIs (monoamine oxidase inhibitor)
28
How long do antidepressant usually take to work? What is the risk during this time?
Usually take 10 days to start working and 4-6 weeks until fully effective. Potential increase anxiety and suicidal ideation in first few weeks of Tx.
29
What is the first line treatment of antidepressants? Give an example of 3 drugs in its class:
SSRIs - fluoxetine, sertraline, citalopram
30
What are the symptoms of SSRI withdrawal syndrome?
Dizziness Nausea Headache Sweating
31
Which class of antidepressant is most effective in the treatment of bulimia nervosa?
SSRI
32
List the 7 SSRI side effects:
``` (7 S's) Sleep difficulties Suicidal thoughts Stress (anxiety) Stomach upset Size (weight) Sexual dysfunction Serotonin syndrome ```
33
List 5 indications for anti-depressants:
- Depression - OCD - GAD - Panic disorder
34
What antidepressant is best used in nocturnal enuresis?
TCAs (e.g. amitriptyline)
35
Give an 3 examples of TCAs:
- Amitriptyline - Clomipramine - Imipramine
36
What are the SE of TCAs?
(TCA): T - Toxic to heart (arrhythmia, heart block) C - CNS (dizziness, sleep problems, confusion) A - Anticholinergic (dry mouth, urinary retention)
37
Give 3 features of a TCA overdose. What is the treatment for TCA overdose?
- Seizures - Hypotension - Sinus tachycardia Rx: - ABCDE - Activated charcoal (if <1hour) - Sodium bicarbonate for cardiac issues - Diazepam for seizures
38
What anti-depressant is typically used for major depression or GAD? and give one example of one:
SNRIs - Duloxetine
39
What the the SE of SNRIs?
S - same as SSRI + H - Hypertension A - Agitation T - Tachycardia
40
When are MAOIs typically used? Give an example of one:
Refractory depression, depression with severe anxiety, phobic disorders (basically complicated pictures. Phenelzine
41
What must be avoided when using MAOIs?
- Food with tyramine-containing foods (hypertensive crisis) | - Use with L-Dopa and TCAs
42
List the 4 side effects of MAOIs:
``` (HAHA): H - Hypotension A - Anticholinergic SE H - Hypertensive crisis A - Anxiety/agitation ```
43
What is serotonin syndrome?
(MAN): 1) Mental status changes (agitation, pressured speech) 2) Autonomic instability (tachycardia, diarrhoea, shivering) 3) Neuromuscular abnormalities (clonus, hyperreflexia, tremor, seizure)
44
What is the treatment for serotonin syndrome?
BZDs
45
List 5 non-pharmacological treatments for depression:
- CBT - Exercise therapy - Psychoeducation - Interpersonal therapy - ECT

Psych (7 decks)

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