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EOR Psych > Psych rotation 2 (1 is flashcards) > Flashcards

Psych rotation 2 (1 is flashcards)

1
Q

Short acting benzodiazepines

A

ATOM

Alprazolam
Triazolam
Oxazepam
Midazolam

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2
Q

Intermediate acting benzodiazepines

A

Tender Loving Care

Tenazepam
Lorazepam
Clonazepam

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3
Q

Long acting benzodiazepines

A

CDeF
Chlordiazepoxide
Diazepam
Flurazepam

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4
Q

MOA of benzodiazepines

A

They increase the FREQUENCY of chloride channel opening –> facilitates inhibitory action of GABA

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5
Q

ADE of benzodiazepines

A

Sedation
tolerance
dependence
ataxia
increased suicide

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6
Q

Contraindications for benzodiazepines

A

suicide risk

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7
Q

caution for benzodiazepines

A

elderly

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8
Q

tx for benzodiazepine overdose

A

flumazenil

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9
Q

how long do you have to have sx before you can be diagnosed with agoraphobia

A

6 months

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10
Q

what is the most common type of phobia

A

social anxiety (disorder) –> social phobia

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11
Q

how long do you have to have sx before you can be diagnosed w social anxiety disorder

A

6 months

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12
Q

what is the mainstay of tx for social anxiety disorder

A

CBT

SSRIs if pharmacologic therapy

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13
Q

tx for performance only social anxiety disorder

A

“as needed”

beta blockers
benzodiazepines

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14
Q

how long do you have to have sx before you can be diagnosed with a specific phobia

A

6 mos

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15
Q

tx for specific phobias

A

exposure and desensitization therapy

short-term benzos or beta blockers in some pts

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16
Q

adjustment disorder

A

maladaptive behavioral or emotional sx develop after a stressful or non-life threatening*** event

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17
Q

when do sx occur and resolve for adjustment disorder

A

within 3 months
resolve within 6 months

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18
Q

how long do you have to have sx to be diagnosed with PTSD

A

sx > 1 month and/or event occurred > 1 month ago

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19
Q

what med can be helpful for ppl with PTSD and insomnia

A

Trazodone

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20
Q

what med can be helpful for ppl w PTSD and nightmares

A

Prazosin

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21
Q

MOA prazosin

A

alpha 1 agonist

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22
Q

Tx for PTSD

A

Psychotherapy

SSRIs and SNRIs first line medical therapy

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23
Q

Sx for serotonin syndrome

A

Anxiety
Agitation
Confusion
N/V
Increased bowel sounds
Diarrhea
Hyperthermia (above 38C)
Clonus
Hypertonia (Increased DTR and hyperreflexia)
Dilated pupils (Mydriasis)

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24
Q

Tx for serotonin syndrome

A

DC med, supportive care, benzos

Cyprohepatine if no response to benzos

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25
Q

Screening for alcohol dependence

A

CAGE
Cutdown
Annoyed
Guilt
Eye opener

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26
Q

How many on CAGE to be diagnosed with alcohol dependence

A

2 or more

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27
Q

Recommended limits for alcohol consumption

A

males </= 65 = less than or equal to 4 drinks per day or less than or equal to 14 drinks per week

males > 65 or females of any age = less than or equal to 3 standard drinks per day or less than or equal to 7 per week

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28
Q

how does the CDC define a drink

A

12 oz beer
8 oz malt liquor
1.3 oz hard liquor
5 oz wine

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29
Q

sx of alcohol intoxication

A

slurred speech
incoordination
unsteady gait
nystagmus
impairment in attention or memory
stupor or coma

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30
Q

onset of alcohol withdrawal

A

6-36 hours after last drink

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31
Q

sx of alcohol withdrawal

A

increased CNS activity

hand tremor
anxiety
irritability
minor agitation
restlessness
insomnia
diaphoresis
palpitations
tachycardia
hypertension
HA
GI (N/V diarrhea)
alcohol craving
loss of appetite

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32
Q

sinus tachycardia

A

> /= 120 BPM

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33
Q

onset of alcohol withdrawal seizures

A

6-48 hours after drinking stops or is significantly reduced

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34
Q

onset of alcoholic hallucinations

A

12-48 hours after last drink and resolves in another 24-48 hours

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35
Q

onset of delirium tremens (withdrawal delirium)

A

2-4 days after last drink

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36
Q

difference btwn alcoholic hallucinations and delirium tremens

A

for delirium tremens, they have abnormal vital signs (tachycardia, HTN, fever, drenching sweats) while ppl w alcoholic hallucinations do not

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37
Q

can alcohol withdrawal be fatal

A

yes

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38
Q

tx for alcohol withdrawal

A

IV benzodiazepines

IV fluids, IV thiamine (B1), multivitamin (including B12 and folate) and electrolyte repletion

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39
Q

what can reduce the risk of Wernicke encephalopthy

A

Thiamine (B1)

40
Q

what meds can be used to treat alcohol addiction

A

Disulfiram
Naltrexone
Topiramate
Gabapentin
Acamprosate

41
Q

sx of marijuana intoxication

A

euphoria
giddiness
anxiety
disinhibition
intensification of sensory experiences
dry (cotton) mouth
increased appetite
motor impairment
conjunctival injection
paranoid delusions
hallucinations

42
Q

up to how many days can urine drug test detect cannabis

A

4-6 days in occasional users
up to 50 days in chronic users

43
Q

sx of marijuana withdrawal

A

irritability
insomnia
depression
restlessness
diaphoresis
diarrhea
twitching

44
Q

what does PCP stand for

A

Phencyclidine

45
Q

street name for PCP

A

angel dust

46
Q

MOA PCP

A

NMDA glutamate receptor antagonist

47
Q

sx of PCP use

A

hallucinations (visual and auditory)
psychosis and delirium
psychomotor agitation (movements that have no purpose)
nystagmus
aggression/violent behavior
anesthesia and analgesia
marked HTN and tachycardia

48
Q

what will you see on PE for PCP use

A

multidirectional nystagmus
marked HTN and tachycardia
dry skin

49
Q

tx for PCP

A

place in low stimulus environment
supportive
parenteral benzodiazepines
antipsychotics (Haloperidol)

50
Q

most deaths for PCP are related to

A

trauma - bc PCP is an analgesic and anesthetic

51
Q

what does LSD stand for

A

lysergic acid diethylamide

52
Q

sx of LSD use

A

hallucinations (visual and auditory)
euphoria
depersonalization
distrustful

53
Q

does LSD cause dependence of withdrawal

A

no

54
Q

MOA LSD

A

action at 5-HT receptor

55
Q

long-term consequences of LSD use

A

flashbacks years later

56
Q

tx for LSD use

A

antipsychotics (haloperidol)
benzodiazepines
supportive counseling

57
Q

common inhalants

A

toluene
butane

58
Q

sx of inhalant

A

euphoria
disorientation
slurred speech
perinasal and perioral rash/sores

59
Q

tx for inhalant use

A

no tx/supportive care
antipsychotic (haloperidol) if aggressive

60
Q

strong opioid agonists

A

fentanyl
heroin
morphine
meperidine
hydromorphone
hydrocodone
methadone

61
Q

moderate opioid agonists

A

oxycodone
hydrocodone
codeine

62
Q

other opioid agonists (not strong or moderate)

A

dextromethorphan (antitussive)
loperamide and diphenoxylate (antidiarrheal)

63
Q

sx of opioid use

A

euphoria followed by sedation
impaired attention
pinpoint pupils
constipation
hypotension
bradycardia
seizures

64
Q

triad for opioid intoxication

A

pinpoint pupils
constipation
comatose state

65
Q

tx for opioid overdose

A

naloxone (short-acting)

66
Q

MOA of naloxone

A

opioid receptor antagonist

67
Q

sx of opioid withdrawal

A

lacrimation
rhinorrhea
pruritus
N/V
abdominal cramping
diarrhea
sweating
yawning
joint pain (arthralgia)
myalgia
dysphoria
restlessness
piloerection
pupillary dilation
increased bowel sounds
HTN
tachycardia

68
Q

is withdrawal from opioids life-threatening

A

no

69
Q

tx for opioid withdrawal

A

clonidine
methadone
buprenorphine + naloxone (Suboxone)

70
Q

MOA clonidine

A

alpha 2 agonist

71
Q

what is used primarily for sx of opioid withdrawal

A

clonidine

72
Q

ADE methadone

A

QT prolongation

73
Q

ADE naltrexone

A

can precipitate withdrawal if used within 7 days of heroin use

74
Q

sx of benzodiazepines intoxication

A

loss of coordination (ataxia)
anterograde amnesia (inability to form new memories)
hypotension
bradycardia
coma
death

75
Q

sx of benzodiazepine withdrawal

A

anxiety
insomnia
seizures
tremor

76
Q

which benzodiazepines has the higher risk of dependence: short or long acting

A

short-acting due to shorter half life

77
Q

tx for benzo OD

A

flumazenil

78
Q

why should you use flumazenil with caution

A

can cause seizures (just like withdrawal)

79
Q

tx for benzo withdrawal

A

long-acting benzo

80
Q

describe sx for barbiturate intoxication and withdrawal

A

v similar to benzos but these are more severe bc no “ceiling”

81
Q

how long should you taper benzos to prevent withdrawal

A

4-6 weeks

82
Q

what med can be added during benzodiazepine taper

A

anti seizure meds (Carbamazepine or phenobarbital)

83
Q

what is the major metabolite of cocaine

A

benzoylecgonine

84
Q

sx of cocaine intoxication

A

decreased appetite
pupillary dilation
HTN
angina
placental infarction
nasal septum perforation
stroke/CVA
tachycardia/tachydysrhytmias
hyperthermia
cold sweats
agitation and aggression
stereotyped behavior (repetitive motions)

85
Q

cocaine withdrawal sx

A

severe depression and suicidality
hyperphagia
fatigue
severe craving
constricted pupils

86
Q

tx for cocaine intoxication

A

benzos
antipsychotics are second line

87
Q

what promotes excretion of cocaine

A

vitamin C

88
Q

why should you not restrain pts w cocaine intoxication

A

can cause rhabdo

89
Q

MOA cocaine

A

inhibition of reuptake of dopamine, NE, and E

90
Q

how long is cocaine detected in urine

A

2-4 days
up to 2 weeks in chronic users

91
Q

symptomatic or refractory HTN caused by cocaine can be treated with

A

phentolamine (alpha adrenergic antagonist)

92
Q

ADE of varenicline

A

nausea (MC)
increased suicidality or neuropsychiatric conditions

93
Q

when should therapy of varenicline begin and end

A

start 1 week prior to quitting and continue 4 months after quit date

94
Q

MOA varenicline

A

blocks nicotine receptors
partial agonist of alpha 4 beta 2 nicotinic receptors –> prevents reward and withdrawal

95
Q

5 A’s for assessing for tobacco use and addressing smoking cessation (in order)

A

ask
advise
assess
assist
arrange

EOR Psych (8 decks)

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