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Psychiatry Shelf > Psychopharm > Flashcards

Psychopharm Flashcards

(61 cards)

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1
Q

lithium tox - sx, tx

A

nausea, vomiting, slurred speech, ataxia, incoordination, myoclonus, hyperreflexia, seizures, delirium, coma, nephro DI
hydrate dialysis

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2
Q

TCA tox - sx, tx

A

ACh, cardiac issues, hypotension, respiratory depression, agitation, hallucinations, CNS stim, depression, seizures

monitor EKG, give bicarb activated charcoal, cathartics, supportive treatment

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3
Q

meds that can cause psychosis

A

corticosteroids, antiparinson, anticonvulsants, antihistamines, anticholinergic, antihypertensives, dig, methylphenidate, fluoroquinolones

  • alchol, cocaine, hallucinogens, marijuana, benzos, barbs, PCP
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4
Q

drug that causes irreversible retinal pigmentation

A

thioridazine

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5
Q

drug that causes agranulocytosis

A

clozapine

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6
Q

litihium - side effects

A 
weight gain
tremor
GI
fatigue
cardiac arrhythmias
seizures
goiter
leukocytosis
coma
polyuria
polydipsia
alopecia
metallic taste
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7
Q

disulfiram

A

blocks aldehyde dehydrogenase, so causes hangover in patients,

contraindicated - cardiac disease, pregnancy, psychosis

monitor liver function

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8
Q

naltrexone

A

opioid receptor blocker

decreases craving

good for patients with hisotry of alcohol abuse

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9
Q

acamprosate

A

postdetox for relapse prevention

used in patients with liver disease

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10
Q

topiramate

A

anticonvulsant that potentiates GABA, inhibits glutamate recetpors

reduces cravings for alcohol

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11
Q

drug that mimics schizo

A

amphetamine psychosis

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12
Q

flumazenil

A

benzo antagonist short acting for overdose

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13
Q

barb overdose treatment

A

alkalinize urine with sodium bicarb to promote renal excretion

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14
Q

naloxone

A

treatment of choice for opiate overdose

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15
Q

opioid producing large pupils

A

demerol dilates pupils

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16
Q

opioid overdose mnemonic

A

Rebels Admire Morphine

respiratory depression
AMS
Miosis

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17
Q

methadone

A

long acting opioid receptor agonist

  • use in pregnant women
  • can cause QTc prolongation
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18
Q

buprenorphine

A

partial opioid receptor agonist

  • suboxone
  • overdose unlikely
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19
Q

TCA use in elderly

A

nortriptyline, fewest anticholinergic

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20
Q

primary tx of depression in elderly

A

SSRIs

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21
Q

tx of tourette’s disorder

A

psychopharm

- atypical antipsych, alpha 2 agonists, typical antipsych

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22
Q

tx of depersonalization

A

antianxiety agents or SSRIs for anxiety or depression

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23
Q

tx of pain syndrome

A

SSRI, biofeedback, hypnosis, psychotherapy

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24
Q

tx of explosive anger

A

SSRI, anticonvulsant, lithium, propranolol

- loiw levels of serotonin

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25
anti histamine side effects
sedation, weight gain in TCA, low potency antipsych
26
anti adrenergic side effects
hypotension in TCA, low potency antipsych
27
anti muscarinic side effects
dry mouth, blurred vision, urinary retention in TCA, low potency antipsych
28
foods with tyramine
red wine, cheese, chicken liver, cured meats
29
tx/cause of EPS
benztropine, high potency antipsych
30
CYP450 inducers (4)
smoking (1A2), carbamazepine (1A2, 2C9, 3A4), barbiturates (2C9), st john's wort (2C`9, 3A4)
31
CYP450 inhibitors (5)
fluvoxamine (1A2, 2D6, 3A4), fluoxetine (2C19, 2C9, 2D6), paroxetine (2D6), duloxetine (2D6), sertraline (2C19)
32
time course of antidepressants
1-2 months
33
SSRI approved for OCD
fluvoxamine
34
drug used to augment sexual side effects of SSRIs
buproprion
35
side effects of SSRIs
sexual dysfunction, GI disturbance, insomnia, HA, anorexia, weight loss, restlessness can increase warfarin
36
drug used for people with depression and neuropathic pain
duloxetine
37
venlafaxine caution
can increase blood pressure, do not use with labile BP
38
side effects of trazodone
priapism, sedation, orthostatic hypotension
39
amitriptyline use
chronic pain, migraines, insomnia
40
imipramine use
enuresis, panic disorder
41
clomipramine use
most serotonin, useful in OCD
42
doxepin use
chronic pain
43
TCA overdose tx
sodium bicarb
44
nortriptyline use
chronic pain, less likely to cause orthostatic hypotension
45
desipramine use
less sedating, least anticholinergic
46
complications of TCAs
3Cs - cardiotoxicity, convulsions, coma lethal in overdose
47
way to avoid serotonin syndrome
wait 2 weeks before switching from SSRI to MAOI
48
monitor in lithium patients
litihium levels, creatinine, thyroid levels
49
NMS mnemonic
FALTERED ``` Fever Autonomic instability Leukocytosis Tremor Elevated CPK Rigidity Excessive sweating Delirium ```
50
tx of EPS
benztropine, diphenhydramine, or amantadine
51
mood stabilizer to decrease suicidality
lithium
52
antipsych to decrease suicidality
clozapine
53
factors that affect lithium levels (7)
``` NSAIDS (decr) aspirin dehydration (incr) salt deprivation (incr) sweating (incr) impaired renal function (incr) diuretics ```
54
drug used for treating mixed episodes and rapid cycling bipolar
carbamazepine
55
side effect of carbamazepine
skin rash, GI, CNS, neural tube defects in pregnancy, leukocytosis (useful with clozapine)
56
valproic acid - use, monitor
useful in mixed episodes of bipolar and rapid cycling monitor - LFTs and CBC
57
lamotrigine - use, side effects
bipolar depression use side effects - stevenws johnson syndrome, dizziness, sedation, headaches, ataxia
58
topiramate - use, side effect
impulse control disorder and anxiety side effect - weight loss, hypochloremic non anion gap metabolic acidosis and kidney stones, hepatotoxicity
59
drug used to reverse benzo overdose
flumazenil
60
steps for ECT
general anesthesia, muscle relaxant, generalized tonic-clonic seizure
61
transcranial magnetic stimulation (rTMS) side effects
headaches, rare seizure

Psychiatry Shelf (3 decks)

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