Week 13 Handout Psych Flashcards
What can psychiatric medications interact with during anesthesia?
Psychiatric meds can interact with anesthesia, prolong drug effects, or precipitate crises when stopped abruptly.
How do mental health disorders affect surgical outcomes?
Mental health disorders influence stress responses, analgesic needs, and emergence profiles.
What is the prevalence of psychiatric medications among patients?
Prevalence is high, and many patients take SSRIs, antipsychotics, lithium, or benzodiazepines.
What causes depression in terms of neurotransmitter activity?
Depression is caused by an imbalance of GABAergic activity and glutamatergic activity.
Which neurotransmitter deficiencies are linked to depression?
Depression is linked to serotonin, dopamine, and norepinephrine deficiency.
What are the signs of depression?
Signs include flat affect, poor grooming, lethargy, and high suicide risk.
What medications are commonly used to treat depression?
Meds include SSRIs, SNRIs, TCAs, and MAOIs.
TCAs prolong QT; MAOIs increase risk of HTN crisis (avoid indirect vasopressors). ECT is an alternative treatment.
What should be avoided when treating depression?
Avoid abrupt discontinuation of antidepressants.
What is the relationship between anxiety, PTSD, and GABA?
Anxiety and PTSD are linked to GABA dysfunction, leading to decreased inhibition and increased excitability.
How do cortisol levels affect patients with anxiety and PTSD?
Increased cortisol levels can impair healing and prolong PACU/hospital stay.
What are common symptoms of anxiety in children?
Children aged 2 to 10 may exhibit separation anxiety.
What medications are used to treat anxiety and PTSD?
Meds include SSRIs, SNRIs, benzodiazepines, and beta-blockers (propranolol).
Beta-blockers decrease catecholamine release.
What is the primary neurotransmitter involved in schizophrenia?
Schizophrenia is associated with increased dopamine activity.
What are the signs of schizophrenia?
Signs include poor grooming, disorganized thoughts, hallucinations, delusions, withdrawal, anger, and emotional detachment.
What medications are used to treat schizophrenia?
First-generation and second-generation antipsychotics are used.
Continue antipsychotics to prevent delirium and NMS.
What characterizes bipolar disorder?
Bipolar disorder is characterized by increased norepinephrine leading to mania alternating with depression.
What are common treatments for bipolar disorder?
Common treatments include lithium, valproate, quetiapine, and lamotrigine.
Aripiprazole, olanzapine, and risperidone are used if first-line treatments fail.
What is the therapeutic window for lithium?
Lithium has a narrow therapeutic window of 0.8–1.0 mEq/L.
What are early signs of lithium toxicity?
Early signs include confusion, sedation, muscle weakness, slurred speech, and tremor.
What substances are commonly abused?
Common substances include alcohol, opioids, benzodiazepines, cocaine, meth, and heroin.
What should be done for intoxicated or withdrawing patients before surgery?
Postpone elective surgery in intoxicated or withdrawing patients.
What is important for alcohol-dependent patients during preoperative care?
Alcohol-dependent patients are typically given benzodiazepines instead of alcohol during preoperative care.
What should be screened for preoperatively?
Screen for depression, anxiety, PTSD, schizophrenia, substance abuse, and bipolar disorder.
What medications should be continued preoperatively?
Continue most psych meds, especially SSRIs, SNRIs, and benzodiazepines, to prevent withdrawal symptoms.
