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Flashcards in Psychiatry Deck (139)
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1

HY symptoms of depression

anhedonia
weight changes
sleep changes
poor concentration

2

first line agent in depression

SSRI ALONE (without any other antidepressants)

3

2 exceptions to SSRI use in depression

1. depression + NEUROPATHIC PAIN
2. depression +....
- fearful of weight gain
- sexual SE's
- smoker trying to quit

4

tx depression + NEUROPATHIC PAIN

DULOXETINE

5

tx depression +....
- fearful of weight gain
- sexual SE's
- smoker trying to quit

BUPROPION

6

choice of SSRI + antidepressant in depression

WRONGGGGGGG!!!!!
choose the cleanest= SSRI on its own

7

tx mild depression + sleep problems

MIRTAZAPINE,
since= antidepressant + sedative

8

what to exclude with presentation of mania

COCAINE and AMPHETAMINE use....
thus hx and toxicology

9

first line tx acute mania

LITHIUM

10

PC: 33yo man, brought to emergency room, bipolar, recently started on lithium, combative and punches nurse on the mouth. what's the next best mgmt

ADEQUATE TX> admission to psychiatric unit;
ANTIPSYCHOTICS= first line tx

11

tx acute mania with severe symptoms

atypical antipsychotics

12

tx dysthymia

antidepressant meds + psychotherapy

13

tx atypical depression

MAOIs = usually the correct answer

14

seasonal affective disorder

phototherapy-- 12-18 inches from source of 10,000 lux of white fluorescent light without UV wavelengths for 30 minutes each morning; eyes open, but don't necessarily stare at the light

15

tx of normal bereavement

PSYHCOTHERAPY
never never never pharmacology

16

exception to strict diagnosis of major depressive disorder (5/9 for >6months, for 2 weeks)

if the symptoms are SEVERE ENOUGH

17

emergency situation of psychosis tx

IM atypical antipsychotic> haloperidol

18

tx of schizophrenia with psychotic episode, that is unresponsive to typical ro atypical antipsychotics

CLOZAPINE

19

avoid olanzapine in...

diabetics
obese patients

20

big SE of risperidone

MOVEMENT disorders

21

benefit of quetiapine

lower incised of movement disorders; thus ok to use in pots with movement disorders

22

avoid ziprasidone in patients with...

conduction defects since prolongs QT interval

23

clozapine monitor

CBC, since high risk of agranulocytosis
NEVER THE FIRST LINE TREATMENT

24

ariprazole use

ADJUNCT+ for major depressive disorer

25

only antipsychotic that can be used in pregnancy

lurasidone

26

LEAST likely drug to cause weight gain and diabetes in schizophrenia

1. ARIPRAZOLE
2. ZIPRASIDONE

27

timing of movement side effects with antipsychotics...
HOURS--DAYS

ACUTE dystonia

28

tx of acute dystonia

benztropine
trihexyphenidyl
diphenhydramine

29

timing of movement side effects with antipsychotics...
WEEKS

AKATHASIA

30

tx of akathasia

DECREASE dose
beta blockers
switch to atypical antipsychotics
benzodiazepine