Drugs / treatment > Psychiatry > Flashcards

Psychiatry Flashcards

(58 cards)

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1
Q

What is often needed in the first presentation of schizophrenia?

A

Admission and enforced treatment under the Mental Health Act

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2
Q

What is the first line pharmacological treatment for schizophrenia?

A

A 2nd gen antipsychotic

Risperidone, olanzapine, quetiapine, aripiprazole

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3
Q

What is the second line pharmacological treatment for schizophrenia?

A

A 1st gen antipsychotic

Haloperidol, lurasidone

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4
Q

What is the drug used for treatment resistant schizophrenia?

A

Clozapine

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5
Q

What are the non-pharmacological management options for patients with PTSD?

A

Trauma-focused CBT
Complex CBT

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6
Q

What pharmacological management is there for patients with acute presentation of PTSD?

A

Antidepressants - SSRI or venlafaxine

Antipsychotics - risperidone

Prazosin, mood stabilising drugs

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7
Q

What is the first line management options for anxiety?

A

Psychoeducation + self help
CBT

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8
Q

What are the pharmacological management options for anxiety?

A

SSRI - sertraline then escitalopram
SNRI - duloxetine or venlafaxine

Pregabalin

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9
Q

What class of drugs can be used short term for severe anxiety?

A

Benzodiazepines

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10
Q

What drug is sometimes used to manage palpitations in patients with anxiety?

A

Propranolol

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11
Q

When should SSRI use be followed up in patients with anxiety?

When is this different?

A

General follow up after 2 weeks

For patients under 30 follow up should be after 1 week

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12
Q

What is the first line management of panic disorder?

A

Self-help and CBT

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13
Q

What is the chosen pharmacological management of panic disorder?

A

SSRI - sertraline
SNRI - venlafaxine or duloxetine

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14
Q

What type of drug can be used for the short term management of panic disorder?

A

Benzodiazepines

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15
Q

What is the recommended management of phobia?

A

CBT with exposure therapy

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16
Q

What psychological management is recommended for social anxiety?

A

CBT tailored to social anxiety

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17
Q

What pharmacological management is recommended for social anxiety?

A

SSRI - sertraline is first line
SNRI - venlafaxine

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18
Q

When can beta-blockers be used by patients with social anxiety?

A

For short term moments such as performance anxiety

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19
Q

What should be used to assess the severity of OCD?

A

Y-BOCS

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20
Q

What is the recommended management of mild / moderate OCD?

A

High intensity CBT with exposure & response prevention

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21
Q

What pharmacological management can be offered to patients with OCD?

How / for how long should they be prescribed?

A

SSRIs - fluoxetine, sertraline

  • Higher dose than for depression
  • 12 weeks or more to be effective
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22
Q

If SSRIs are ineffective in managing OCD what can be considered?

A

Clomipramine
(a tricyclic antidepressant)

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23
Q

What is the first recommended management in patients who have personality disorder?

What can also be done?

A

Dialectical behavioural therapy (DBT)

CBT and MBT

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24
Q

What is the first line drug for an acute manic episode in patients with bipolar disorder?

Study These Flashcards
A

Atypical antipsychotic such as:

Haloperidol, olanzapine, risperidone, quetiapine (HORQ)

25
What is the first line choice of management for patients with acute bipolar depression? Remember Quite Friendly Llamas Laugh
Atypical antipsychotics such as: Quetiapine Fluoxetine + olanzapine Lamotrigine Lurasidone
26
What can antidepressants cause in patients with bipolar and is hence why they are generally avoided?
Rapid cycling mood
27
What is the first line management for bipolar maintenance? What are the alternatives?
Lithium Valproate, lamotrigine, olanzapine or quetiapine
28
What is the recommended management of mild depression?
Watchful waiting CBT
29
What is the recommended management of moderate / severe depression?
Combination of an antidepressant medication and high-intensity CBT or interpersonal therapy (IPT)
30
What is the first line pharmacological management for moderate / severe depression?
SSRI - escitalopram, sertraline, fluoxetine
31
What are the second line pharmacological management for moderate / severe depression?
Switch to a different SSRI Switch to SNRI or Tricyclics
32
What is the fourth line pharmacological management of moderate / severe depression?
Venlafaxine or mirtazapine
33
What are the three recommended management steps for young people with unresponsive or moderate / severe depression?
1. CBT, family therapy 2. Fluoxetine 3. Sertraline or citalopram
34
What should be given in the instance of a paracetamol overdose?
N-acetylcysteine
35
What should be given in the instance of an opioid overdose?
Naloxone IV / IM
36
What should be given in the instance of a benzodiazepine overdose?
Flumazenil
37
What should be given in the instance of a tricyclic antidepressant overdose?
IV sodium bicarbonate
38
What should be given within 1 hour of a drug overdose?
Activated charcoal
39
What is the immediate management for postpartum psychosis?
Referral to specialist perinatal mental health services Hospitalisation in a Mother and Baby Unit where possible
40
What are the main pharmacological managements options for postpartum psychosis?
Olanzapine, quetiapine, risperidone
41
What supportive care should be given to patients with postpartum psychosis?
Mother-baby bonding Sleep hygiene Social and family support
42
What are the recommended management options for patients with ADHD?
Psychoeducation Behaviour management CBT strategies
43
What is the pharmacological management options for moderate-severe ADHD?
1st line - stimulant drugs Methylphenidate, dexamphetamine, lisdexamphetamine
44
What are the contraindications for ADHD medications? Remember CHAGS stop the meds!
Cardiac disease Hyperthyroidism Anxiety Glaucoma Substance misuse
45
When should patients with anorexia nervosa be referred for inpatient care?
BMI ≤ 15 kg/m² Rapid weight loss (> 1 kg/week over 4 weeks) Syncope, bradycardia (< 40 bpm), hypotension (< 90/60 mmHg) Electrolyte disturbances High medical or psychiatric risk
46
What is the first line recommended management for patients with anorexia nervosa that are under 18 years of age?
Anorexia-nervosa-focused family therapy
47
What is the first line recommended management for patients with anorexia nervosa?
CBT-ED Maudsley Anorexia Nervosa treatment for Adults (MANTRA) Specialist supportive clinical management (SSCM)
48
What is the first line recommended management for patients with bulimia nervosa that are under 18 years of age?
Bulimia-nervosa-focused therapy
49
What is the first line recommended management for patients with bulimia nervosa?
Guided self help CBT-ED Fluoxetine - up to 60mg daily
50
What is the recommended management for binge eating disorder?
Self-help CBT CBT-ED
51
What is the recommended management of PICA?
CBT Positive reinforcement Habit reversed training Family based interactions Remove access to unsafe substances
52
What are the common side effects of SNRIs?
Nausea Insomnia Agitation Increased HR
53
What are the recognised side effects of SNRIs?
GI upset Anxiety / agitation Sexual dysfunction Hyponatraemia QT interval prolongation
54
Which antidepressant is particularly associated with QT interval prolongation?
Citalopram
55
What are the common side effects of tricyclic antidepressants?
Urinary retention Drowsiness Blurred vision Constipation Dry mouth
56
What are the signs of opiate withdrawal?
Diarrhoea, mydriasis, muscular aches, yawning, runny nose, insomnia Tachycardia, hypertension and goosebumps (piloerection)
57
What is given for opiate withdrawal?
Methadone +/- buprenorphine
58
Which medications are safe for breastfeeding mothers experiencing postpartum psychosis?
Olanzapine Quetiapine
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