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55 Cards in this Set
- Front
- Back
first line pharmacotherapy for depression
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SSRIs
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antidepressants associated with hypertensive crisis
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MAOIs
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galactorrhea, impotence, menstrual dysfunction, and lower libido. these are side effects of what type of medication?
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pt on dopamine agonist
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17yo F has left arm paralysis after boyfriend dies in a car crash. no medical cause is found.
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conversion d/o
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mom who is angry at her husband yells at her child. defense mech.?
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displacement
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pedophile who enters a monastery. defense mech.?
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reaction formation
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woman calmly describes a grisly murder. defense mech.?
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isolation
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hospitalized 10yo begins to wet his bed. defense mech.?
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regression
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life-threatening muscle rigidity, fever, and rhabdomyolysis
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neuroleptic malignant syndrome
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amenorrhea, bradycardia, and abnormal body image in a young female
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anorexia
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a 35yo M has recurrent episodes of palpitations, diaphoresis, and a fear of going crazy
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panic d/o
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most serious side effect of clozapine?
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agranulocytosis
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21yo male has 3 mos of social withdrawal, worsening grades, flattened affect, and concrete thinking
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schizophreniform d/o (dx of schizophrenia requires >= 6mos of sx)
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key side effects of atypical antipsychotics
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wt gain
type 2 DM QT prolongation |
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a young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. dx? tx?
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acute dystonia (oculogyric crisis)
treat with benztropine (anti-cholinergic) or diphenhydramine (Benadryl = antihistamine and sedative) |
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meds to avoid in pts c hx of alcohol w/d seizures
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neuroleptics
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13yo M has a hx of theft, vandalism, and violence toward family pets
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conduct d/o
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5mo old F has decr. head growth, truncal dyscoordination, and decr. social interaction
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Rett's d/o
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a pt hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech. dx? tx?
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acute mania. start a mood stabilizer (eg. lithium or valproic acid)
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after a minor fender bender, a man wears a neck brace and requests permanent disability pmts.
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malingering
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a nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide
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factitious d/o (Munchausen syndrome)
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a pt continues to use cocaine after being in jail, losing his job, and not paying child support
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substance abuse
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a violent pt has vertical and horizontal nystagmus
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phencyclidine hydrochloride (PCP) intoxication
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a woman who was abused as a child frequently feels outside of or detached from her body
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depersonalization d/o
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a man has repeated, intense urges to rub his body against unsuspecting passengers on the bus
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Frotteurism (a paraphilia)
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a schizophrenic pt takes haloperidol for 1yr and develops uncontrollable tongue movements. dx? tx?
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tardive dyskinesia; decrease or d/c haloperidol and consider another antipsychotic (eg. risperidone, clozapine)
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a man unexpectedly flies across the country, takes a new name, and has no memory of his prior life
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dissociative fugue
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Name 5 SSRI's. When are they indicated?
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Citalopram
Escitalopram Fluoxetine Paroxetine Sertraline Indications: first-line therapy for depression and anxiety d/o |
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What are side effects of the SSRI's?
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sexual side effects, decreased appetite, insomnia, HA, tremor
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what can happen if SSRI's are combined with MAOI's?
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serotonin syndrome: fever, myoclonus, mental status changes, CV collapse
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what are the signs and sx of serotonin syndrome?
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fever, myoclonus, mental status changes, CV collapse
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how do you remember TCA toxicity?
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"Three C's and A"
Convulsions Coma Cardiac arrhythmias Anti-cholinergic effects (dry mouth, constipation, urinary retention) |
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what are 2 side effects of chronic lithium use?
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hypothyroidism and nephrotoxicity
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what mood stabilizer can cause a life-threatening rash, aka Stevens-Johnson syndrome?
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lamotrigine
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what can happen if cheese and red wine are consumed while taking MAOI's?
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hypertensive crisis
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Name 5 atypical antidepressants.
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bupropion
mirtazapine nefazodone trazodone venlafaxine |
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what class of drugs may be used to treat OCD, chronic pain and migraines?
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atypical antidepressants.
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which atypical antidepressant is also used as a sleep aid and for erectile dysfunction?
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trazodone
"trampy and trance on trazodone" |
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what antidepressants are used as first line therapy especially because they lack sexual side effects?
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atypicals:
bupropion mirtazapine nefazodone trazodone venlafaxine |
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bupropion: drug class and SE?
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atypical antidepressant
lowers seizure threshold |
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venlafaxine: drug class and SE?
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atypical antidepressant
diastolic hypertension |
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mirtazapine: drug class and SE?
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atypical antidepressant
weight gain and sedation |
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nefazodone: drug class and SE?
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atypical antidepressant
sedation, HA, dry mouth |
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trazodone: drug class and SE?
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atypical antidepressant
highly sedating, priapism |
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name 4 TCA's.
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amitriptyline
nortriptyline imipramine desipramine |
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how can TCA's become lethal?
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overdose leading to cardiac conduction abnormalities
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do MAOI's have sexual side effects?
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yes
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list the symptoms of mania.
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DIG FAST
Distractibility Insomnia Grandiosity and Goals Flight of ideas Agitated psychomotor Sexual indiscretions Talkativeness |
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what are the characteristics of personality disorders?
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MEDIC
Maladaptive Enduring Don't follow cultural norms Inflexible Causes impairment in social functioning |
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name 4 mood stabilizers.
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lithium
carbamazepine valproic acid lamotrigine |
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what drug is used as a mood stabilizer in treatment refractory pts?
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lamotrigine
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this drug, also used for acute mania, is the most widely used bipolar d/o drug.
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valproic acid
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what second-line mood stabilizer is also an anti-convulsant?
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carbamazepine
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what are the 4 indications for lithium?
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1. 1* mood stabilizer
2. acute mania (combine with antipsychotics) 3. prophylaxis of mania and depression in bipolar d/o 4. augment depression tx |
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what are the side effects from taking a dopamine agonist?
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galactorrhea
impotence menstrual dysfunction lower libido |