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Flashcards in Mental Health Deck (119):
1

s/s of serotonin syndrome

fever, muscular rigidity, mental status changes, hyperreflexia, shivering

2

life-threatening idiopathic reaction from typical and atypical antipsychotics

malignant neuroleptic syndrome

3

typical and atypical antipsychotics affect this neurotransmitter

dopamine

4

s/s of malignant neuroleptic syndrome

fever, muscular rigidity, mental status changes, urinary incontinence, changes in BP

5

The Baker Act

allows 72 hours of involuntary detention for eval and trx of those who are at high risk of suicide

6

A questionnaire used to evaluate an individual for dementia and confusion

MMSE

7

adverse effects of atypical antipsychotics

weight gain and DM2

8

olanzapine (Zyprexa)

atypical antipsychotic

9

Rispiradone (Risperdal)

atypical antipsychotic

10

Quetapine (Seroquel)

atypical antipsychotic

11

Haloperidol (Haldol)

typical antipsychotic

12

chlorpromazine

typical antipsychotic

13

adverse effects of typical antipsychotics

elevated lipids

14

Black box warning for typical antipsychotics

high risk of death to frail elderly

15

carbamezapine (Tegretol)

anticonvulsant

16

Lamotragine (Lamictal)

anticonvulsant

17

adverse effect of Lamictal

SJS

18

black box warning for SSRIs

high risk of suicide ideation, esp in those less than 24

19

bupropion (Wellbutrin)

atypical antidepressant

20

bupropion (Wellbutrin) is contraindicated in

those with hx of seizures, anorexia, bulimia

21

venlaxafine (Effexor)

SNRI

22

duloxetine (Cymbalta)

SNRI

23

adverse effects of SNRI

can precipitate acute narrow-angle glaucoma

24

Do not combine these SSRIs with this medication as it may increase risk of serotonin syndrome

MAOIs

25

antidepressant that is category X

TCA

26

SSRI with the longest half life

fluoxetine (Prozac)

27

This SNRI can trx both depression and neuropathic pain

Duloxetine (Cymbalta)

28

side effects of SSRI

weight gain, sexual dysfunction, insomnia

29

SSRIs can induce

manic phase in bipolar patients

30

imipramine (Tofranil)

TCA

31

amitriptyline (Elavil)

TCA

32

nortryptyline (Norpramine)

TCA

33

Phenelzine (Nardil)

MAOIs

34

tranylcypromine (Parnate)

MAOIs

35

Wait until ____ before initiating SSRI or TRCA therapy after use of MAOIs

2 weeks

36

Avoid eating these foods with MAOI

high tyramine foods: beer, chianti wine, aged cheese, fava beans

37

Do not discontinue benzos abruptly because it increase risk of

seizures

38

ultra short acting benzo

IV midazolam (versed)

39

medium acting benzo

alprazolam (xanax), lorazepam (Ativan)

40

long-acting benzo

diazepam (valium), clonazepam (Klonopin), temazepam (Restoril)

41

Depression is due to dysfunction of the neurotransmitters

norepinephrine and serotonin

42

diminished interest or pleasure in all of most activities

anhedonia

43

rule these out before making a diagnosis of depression

anemia, hypothyroidism, B12 deficiency, daibetes

44

Patients taking SSRI with sexual dysfunction

add bupropion

45

drug interactions with St. John's wort

oral contraceptives, SSRI, TCA, MAOI

46

drug interactions with kava kava and valerian root

benzo, hypnotics

47

examples of MMSE

date, location, repeat 3 listed things, count backwards, spell "WORLD" backwards, write a sentence, copy figure

48

impaired MMSE score

less than 24

49

decreases the effectiveness of digoxin

st. john's wort

50

adverse effects of antipsychotics

extrapyramidal symptoms: pill-rolling, shuffling gait, bradykinesia, akinesia

51

inability to initiate movement; can be an adverse effect of antipsychotics

akinesia

52

a strong inner feeling to move, unable to stay still; can be an adverse effect of antipsychotics

akathisia

53

involuntary movements of the lips (smacking), tongue, face, trunk, and extremities

tardive dyskinesia

54

alcohol limit guidelines for americans

women: 1 drink/day; men: 2 drinks/day

55

binge drinking is

more than 5 drinks on a single occasion in males (4 in females)

56

lone elevation of this is a possible sign of alcohol abuse

GGT

57

lab with alcoholic hepatitis

AST is double the level of ALT

58

CAGE questionaire

C: Do you feel the need to CUT down?
A: Are you ANNOYED when people make comments about your drinking?
G: Do you feel GUILTY about your drinking?
E: Do you need to drink EARLY in the morning?
(positive if more than 2/4)

59

Meds for alcoholics

disulfiram (Antabuse), Naltrexone (Vivitrol)

60

side effect of Antabuse

severe N/V, headache

61

s/s of Korsakoff's syndrome

confusion, coma, hypotension

62

trx for Korsakoff's syndrome

high dose thiamine (B1)

63

chronic insomnia is for

more than 3 weeks

64

s/s of anorexia

xerosis, lanugo, peripheral edema, amenorrhea

65

anorexic patients are at high risk of

osteoporosis

66

SSRI with highest side effect of erectile dysfunction

Paxil

67

complications of anorexia

hypotension, bradycardia, mitral valve prolapse

68

s/s of bulimia

normal weight, hypotension, tachycardia, parotid gland swelling, erosion of tooth enamel.

69

bulimia is associated with

diabetes

70

first line medication for bulimia

fluoxetine (Prozac)

71

an illness fabricated by the parent

Munchausen by proxy

72

the reason for hypoactive sexual disorder

low testosterone

73

PDE5 inhibitors

sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis)

74

contraindication of those taking PDE5 inhibitors with

nitrates

75

education about Viagra and Levitra

have rapid onset of action and work for a short period of time. best to take on empty stomach; avoid with high fat meal

76

education about tadalafil (Cialis)

long half life; no diet limitations

77

undesirable physical events or experiences that occur during entry in sleep.

parasomnias

78

cocaine is a

stimulant

79

GAD are symptoms of anxiety for more than

6 months

80

s/s of GAD

restlessness, fatigue, difficulty concentrating, irritability, sleep disturbance

81

problem with discontinuing benzo

rebound insomnia

82

side effects of SSRIs in older adults

hyponatremia, bleeding, osteoporosis, serotonin syndrome

83

TCA carry a high risk of

cardiac dysrythmias

84

s/s of anxiety in adolescents

anger and disobedience

85

s/s of panic disorder

symptoms peak in 10 min with palpitations, sweating, trembling, SOB, nausea, lightheadness

86

first line trx for OCD

exposure and response prevention (CBT)

87

inability to interpret sensory information

agnosia

88

inability to perform purposeful action

apraxia

89

progressive cognitive decline, common in those greater than 60

alzheimer's dementia

90

fluctuating cognition associated with parkinsonism, hallucinations and delusions, gait difficulties, and falls.

Lewy body dementia

91

trx for mild dementia

cholinesterase inhibitors

92

donepezil (Aricept)

cholinesterase inhibitors

93

rivastigmine (Exelon)

cholinesterase inhibitors

94

for moderate to severe dementia

cholinesterase inhibitors, memantine (Namenda), or antipsychotics

95

Neurologic complication of illness and/or medication, especially common in older patients, manifested by new confusion and impaired attention.

delirium

96

impairment of effective social and communication skills

autism

97

s/s of major depressive disorder

symptoms for more than 2 weeks: feeling or worthlessness, depressed mood, loss of interest, weight change, sleep pattern change

98

Major depressive disorder is associated with low levels of

serotonin

99

Major depressive disorder in children is characterized as

irritability

100

dosage for escitalopram (Lexapro)

5-20 mg

101

dosage for citalopram (Celexa)

10-60 mg

102

dosage for sertraline (Zoloft)

50-200 mg

103

dosage for paroxetine (Paxil)

20-60 mg

104

dosage for fluoxetine (Prozac)

10-80 mg

105

SSRI that can be used for also for premenstrual dysphoric disorder

fluoxetine (Prozac)

106

dosage for duloxetine (Cymbalta)

20-60 mg

107

dosage for venlaxafine (Effexor)

75-375 mg

108

dosage for bupropion (Wellbutrin)

200-450 mg

109

defined by one or more manic or mixed episodes during a patient’s lifetime

Bipolar I

110

at least one major depressive episode are met in addition to at least one hypomanic episode.

Bipolar II

111

lab to do before starting on TCA

EKG

112

At least of these symptoms are needed to diagnose with depression

SIG E CAPS:
Sleep issues
Interests
Guilt or worthlessness
Energy
Concentration difficulties
Appetite
Psychomotor agitation or irritation
Suicidality

113

Anticipatory guidance about SSRI therapy in young to middle age adult

takes 2-4 weeks to see improvement and 6-12 weeks to have relief of symptoms

114

Anticipatory guidance about SSRI therapy in older adult

takes 4-8 weeks to see improvement and 12-16 weeks to have relief of symptoms

115

SSRIs can increase risk of

bleeding, especially if on ASA or blood thinners

116

TCA side effects in elderly

confusion, hallucinations

117

benzos with highest rate of addiction

those with shortest half life: xanax and ativan

118

GABA and serotonin affect

wellbeing, calmness

119

norepinephrine and dopamine affect

productivity, ambition, concentration