Psych Flashcards
(33 cards)
MDD with atypical featrures tx
1) SSRIs
2) MAO-Is
MDD with seasonal pattern
light therapy (10K Lux at least 30 min/day)
Tx of serotonin syndrome
- Discontinue all serotnergic agents (sxs usually resolve in 24 hours)
- Supportive care to normalize vital signs (use short acting agents for tachycardia or hypertension like esmolol or nitroprusside)
- Sedation with benzos. If agitation persistns, use cyproheptadine
- If temp >41.1 C sedate, paralyze and put an ET tube in then mechanically cool pt with ice blankets or misting fans
TCA overdose management
- ABCs
- Activated charcoal 1g/kg up to 50 kg (dont use if ileus or pt can’t protect airway)
- If QRS >100msec treat with Na Bicarb
- If hypotensive treat with IVF and then norepi if that doesnt work
- If agitated or develops seizures treat with benzos (not phenytoin)
tx of bipolar disorder
1) Mood stabilizers such as lithium (CI in renal failure) and anticonvulsants (valproic acid, carbamazepine, lamotrigine)
2) atypical antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone)
3) ECT
*If bipolar presents in depressive state DO NOT give SSRI or SNRI b/c can induce mania. Still treat with mood stabilizer
treatment of nephrogenic diabetes insipidus caused by lithium
HCTZ (all NDI) and amiloride (specific to lithium)
Panic disorder treatment
CBT, SSRI, Benzos for acute attacks
generalized anxiety disorder tx
SSRI, SNRI, Buspirone, CBT
Social anxiety disorder treatment
CBT, SSRI, SNRI, Benzo or BB as needed for performances
anxiety medications
1) SSRI, SNRI
2) Buspirone (affinity for serotonin and dopamine receptors)
specific phobia treatment
exposure therapy (systemic descensitization)
acute dystonia tx
benztropine (anticholinergic like atropine) or diphenhydramine
tx of parkinsonian symptoms associated with high potency antipsychotics
anticholinergics (benztropine), amantadine (facilitates the release of dopamine)
Neuroleptic malignant syndrome treatment
- Stop offending med
- Supportive care in ICU (IVF, lower temp (can use tylenol), clonidine or nitroprusside for hpertension, DVT prevention with heparin or enoxaparin, benzos for agitation)
- Dantrolene (prevents Ca release from sarcoplasmic reticulum)
- Other possibilities include bromocriptine (dopamine agonist) and amantadine (increase dopamine release)
Benzodiazepines reversal
flumazenil
amphetamine and cocaine toxicity treatment
benzos, antipsychotics, (no BB) and phentolamine
nicotine treatment
nicotine replacement, buproprion, vareniciline (can cause vivid dreams and depression)
Hallucinogens (LSD, mescaline, ketamine) treatment
calm environment, antipsychotics if AMS, benzos if aggitated or anxious
PCP treatment
benzos and antipsychotics
long term treatment of alcholism
-Group therapy
First line pharmacoptherapy:
Naltrexone (decrease positive feelings with alcohol use)
- Disulfiram
- Topiramate (decrease cravings)
- Acamprosate
anorexia treatment
1) psycotherapy
Pharmacology is usually ineffective. But if theres comorbid depression, use SSRI
*Buproprion contraindicated due to risk of seizures
Bulimia nervosa treatment
CBT and SSRI
Binge eating disorder treatment
1) Cognitive behavioral therapy
2) SSRI, topiramate, stimulants
PTSD treatment
Psychotherapy
SSRIs (first line)
Prazosin (a1 blocker) reduces nightmares and improves sleep
*Avoid Benzos due to lack of efficacy and risk of abuse
