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Flashcards in Psychiatry Deck (30):
1

MOA of risperidone?

Side effect?

It is a dopamine antagonist

meaning that it will cause galactorrhea (due to non-inhibition of prolactin)

2

MOA of primidone?

Side effect?

Anticonvulsant

can cause acute intermittent porphyria

3

What is the side effect of the SSRI Imiprimine?

It causes increased prolactin, so it can cause infertility and galactorrhea!

4

What is a long term side effect of buspirone?

Seizures

Ppl mainly take this for GAD, OCD, PTSD

5

OCD vs OC personality disorder?

OCD = the pts know that what they are doing is crazy and want to get rid of their behaviors

OCPD = pts think their actions are ok

6

Panic Disorder

Pt has panic attacks, avoids areas that may make them panic, fear of public areas (agoraphobia) and has concern (>1 month) about having additional attacks

7

Differentiate:

MDD
Atypical Depression
Double Depression
Adjustment Disorder
Dysthymia

MDD = 2 weeks of 7 SIGECAPs

Atypical = weight gain, hypersomnia, and rejection sensitivity

Double = major depressive episode w/ dysthymia (2 years of depressed mood.)

Adjustment = Some SIGECAPs but not all, occurs 3 months after an identifiable stressor

Dysthymia = milder, chronic depression for most of the time for 2 years. Resistant to tx.

8

TCA toxicity?

3 C's

Convulsions
Coma
Cardiac Arrythmias (long QTc)

9

MUST BE OFF SSRI'S FOR 2 WEEKS BEFORE STARTING AN MAOI

MUST BE OFF FLUOXETINE FOR 5 WEEKS

10

Differentiate:
Postpartum blues
Postpartum psychosis
Postpartum depression

blues = 2 weeks PP, sad, no thoughts of harm
psychosis = 2-3 weeks PP, delusions, thoughts of harm
depression = 1-3 months PP, all of the above + sleep issues and anxiety. Thoughts of harm!

11

Differentiate:
BP 1
BP 2
Cyclothymic
Rapid Cycling

BP1 - at least 1 manic or mixed episode (at least 1 week long)
BP2 - at least 1 major depressive episode AND 1 HYPOmanic episode
Cyclothymic - chronic, less severe alternating periods of hypomania and moderate depression for >2 years
Rapid Cycling - 4+ episodes of depression or mania in 1 year!

12

Antidepressants in a BP patient can cause them to go into mania

Always start your mood stabilizers first

13

Serotonin syndrome

fever, myoclonus, mental status changes

14

Paroxetine can cause what in fetus?

Pulmonary HTN, avoid in pregnant pts

15

Side effects of mirtazepine?

Venlafaxine?

MAOi?

Weight gain and sedation

Ven = diastolic HTN

MAOi = HTN crisis if taken w/ tyramine foods. also causes weight gain and ortho hypotension

16

Avoid lithium in RF pts

It has a narrow TI and can cause decreased renal function if levels are too high

17

Side effects of carbamaxepine?

Valproate

Lamotrigine

carb = nausea, rash, aplastic anemia, SJS

Valproate = GI side effects, agranulocytosis

Lamotrigine = blurry vision, SJS (increase dose slowly!)

18

Schizoid vs anti social vs avoidant

schizoid = avoid. No emotions. loners

anti-social = break laws, impulsive. in child hood this is called Conduct Disorder

avoidant = rejection sensitive and fear of being disliked so thats why they avoid

19

Schizoaffective vs Schizophreniform

Affective = symptoms of schizophrenia and either depression or BP

Schizophreniform = schizophrenia symptoms for

20

MOA of typical antipsychotics (haldol, chlorpromazine etc.)

Side effects?

MOA = D blockers (treats + symptoms)

can cause EPS or hyperprolactinemia
can cause anticholinergic effects
QTc elongation
NMS

THORIDAZINE CAUSES IRREVERSIBLE RETINAL PIGMENTATION

21

MOA of atypical antipsychotics (clozapine, risperidone, aripiprazole, olanzapine, quetiapine)

Side effects?

dont know MOA. dont use clozapine unless everything else fails (it causes agranulocytosis and needs to have a weekly CBC.)

Can all cause weight gain and t2DM, but less EPS symptoms!

22

EPS side effects?

4 hours - acute dystonia (twisted neck) tx = anticholinergics
4 days - akinesia. (pseudo parkinsons) tx = anticholinergics
4 weeks - akathesia. (restlessness) tx = BBs and antichol
4 months - TD. d/t chronic D blockade. tx = anticholinergics (although these may worsen the symptoms at first!) and change drug to clozapine or risperidone (atypicals)

23

Differentiate:
Aspergers
Rett
Childhood disintegrative disorder

Aspergers = autism but w.o the language or cognitive delays

Rett = neurodegenerative disorder in girls (impairment in language, head growth, and coordination after 5 months of normal development.)

Childhood dis = developmental regression > after 2 years of normal development (language, bowel control, motor skills etc..)

24

Mild, moderate, or profound Mental Retardation

mild = IQ of 50-70
mod = IQ of 35-49
profound = IQ

25

What do pupils look like in these abuses:
opioids
amphetamines
cocaine
PCP

opioids - constriction
amphetamines - dilation
cocaine - dilation
PCP - vertical/horizontal nystagmus

26

People with anorexia nervosa may still binge/purge

differentiate it from bulemia if they are underweight and dont see anything wrong with what they are doing

DONT GIVE BUPROPRION TO EATING DISORDER PTS B/C IT CAN LOWER THE SEIZURE THRESHOLD!

27

lanugo

soft fine hairs that grow on pts with eating disorders

28

Tx for narcolepsy?

Naps, benzos (stimulants) and/or SSRI's if they have cataplexy (sudden loss of muscle tone)

29

How are factitious disorders and malingering different from somatoform disorders?

Somatoform disorders have no conscious control or intentional process!

malingering = they are pretending to be sick for a tangible gain

30

Conversion vs Somatoform?

somatoform - multiple symptoms in different organ systems

conversion - motor/sensory function disorders linked to a relationship of stress