PTSD Flashcards Preview

NeuroPsych > PTSD > Flashcards

Flashcards in PTSD Deck (30):
1

True/False: PTSD is a normal event that happens after a traumatic event

False. It is an anxiety disorder that follows a traumatic event and is debilitating to those it affects

2

Risk factors for developing PTSD

Woman - more sx and longer duration
Events involving masses of people
Sudden/unexpected loss of a loved one

3

Three Core Sx of PTSD and how many of each is needed for dx

Re-experiencing: 1
Avoidance: 3
Arousal: 2

4

What is required in the DSM-IV of the event?

Experienced/witnessed by patient
In real danger of death/injury
Response was fear, horror, etc

5

How long do sx have to cause distress/impairment until before being able to be diagnosed?

1 month

6

Explain the difference between acute, chronic and delayed onset PTSD

Acute <3 months
Chronic ≥3 months
Delayed onset not seeing sx until at least 6 months after the event

7

Comorbid Disease State Considerations

MDD
Anxiety
Substance Abuse
Sleep disorders
Suicidal Ideation

7

Comorbid Disease State Considerations

MDD
Anxiety
Substance Abuse
Sleep disorders
Suicidal Ideation

8

First Line

SSRI
Helps with: sleep, nightmares, re-experiencing
Does not help with: Avoidance sx
Dosing: Start low and go slow
Adequate trial length: 6-8 weeks

8

First Line

SSRI
Helps with: sleep, nightmares, re-experiencing
Does not help with: Avoidance sx
Dosing: Start low and go slow
Adequate trial length: 6-8 weeks

9

Which SSRI do we avoid and why?

Paxil
Lots of Anti-Ach - hypotension
Weight gain

9

Which SSRI do we avoid and why?

Paxil
Lots of Anti-Ach - hypotension
Weight gain

10

What side effects are most common?

GI upset when initiating and changing dose
Sexual dysfunction

10

What side effects are most common?

GI upset when initiating and changing dose
Sexual dysfunction

11

What side effects are rarer and more serious?

GI bleed
SR syndrome
SIADH

11

What side effects are rarer and more serious?

GI bleed
SR syndrome
SIADH

12

2nd Line

SNRI
Helps with: PTSD and 2˚ pain
Dosing: ER formulation ONLY
Adequate trial length: 6-8 weeks

12

2nd Line

SNRI
Helps with: PTSD and 2˚ pain
Dosing: ER formulation ONLY
Adequate trial length: 6-8 weeks

13

What SNRI side effects are most common?

GI upset
Headache
Agitation
Insomnia
Sexual dysfunction

13

What SNRI side effects are most common?

GI upset
Headache
Agitation
Insomnia
Sexual dysfunction

14

Which SNRI AEs are rarer and more serious?

SR syndrome
GI bleed

14

Which SNRI AEs are rarer and more serious?

SR syndrome
GI bleed

15

Which medications have the worst d/c syndrome?

Paxil and Effexor

15

Which medications have the worst d/c syndrome?

Paxil and Effexor

16

Third Line

Phenelzine (MAOi)
Remeron

16

Third Line

Phenelzine (MAOi)
Remeron

17

Adjunct or 1˚ Treatment for Nightmares in PTSD

Name: Prazosin
MOA: alpha 1 blocker
Why this over other in same class? Crosses BBB
Clinical effect: Reduces night terrors, more REM sleep
Dosing: Start at 1mg at bedtime and titrate based on ADRs and effect
Monitoring: Orthostatic hypotension

17

Adjunct or 1˚ Treatment for Nightmares in PTSD

Name: Prazosin
MOA: alpha 1 blocker
Why this over other in same class? Crosses BBB
Clinical effect: Reduces night terrors, more REM sleep
Dosing: Start at 1mg at bedtime and titrate based on ADRs and effect
Monitoring: Orthostatic hypotension

18

What do we avoid in PTSD?

BZDs
TCAs

18

What do we avoid in PTSD?

BZDs
TCAs