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Psych I

LECOm Psych

Ericson showed life cycles as battle VS
2 social learning people Mahler and Bowlby
Self model sees normal/abnormal as additive of these 4 DSBP; Developmental, Social Learning, Behavioral, Psychoanylitical
Maslow said you can only move up once all the prerecs are met
Piaget is credited with todays 2 school curriculum
Disease model sees abnormal behavior as “what the Pt has”
Dimensional model sees abnormal behavior as what a Pt is in terms of numbers, gradations, aka normal is under the curve
Public Law 102-321 gave block grants specifically to help those with DSM Dx that intereveres with life activities
Medicare Modernization act of 64 effected psych by giving 65 and over access to care but also increased homeless population by freeing those institutionalized that didn’t act as a threat to themselves or others
Criminalization of psychiatric illness means those who are ill are being jailed
Psyching of criminal behavior refers to criminals malingering into psych treatment
Thorazine/chlorpromazine was the first antipsychotic ish
Mnemonic for 5HT. NE, and dopamine blockade FAS=3-1-0; I  D= 30,23; P=030
Valproic acid should be Rx to women only after they are pregnancy tested and told they can’t have unprotected sex
Monitor in elder on litium CBC, EKG, UA
Bupropion has the safety advantage of few drug-drug interactions
Litium is removed by urination, it’s distributed in water and only dialysis can get it out
Litium is used in bi-polar patients when then are alcoholics because litium decreases drinking
Clomipramine is the first drug approved for OCD
TCA dosing should be slow and once effect is reached you should reduce to the lowest active level
Bupropion is tolerated well because it does not have sexual side effects
Only SSRI for children is Prozac aka fluoxetine
Monitor this in children taking SSRI suicidal thoughts
2 drug classes that should be avoided together to avoid serotonin syndrome MAO-I and SSRI
SSRI’s have the advantage of decreased autonomic action
Fluoxetine’s metabolite norfluoxetine has a half-life of 7-9 days
STAR*D studied showed that failure of treatment with citalopram followed by Tx w/ bupropion, sertraline or venlafaxine, is possible in 25% of Pts
SE of citalopram QT prolongation
Difference in euthymia and mood disorder is when the normal mood beings to interfere with success and happiness
Depression mnemonic SIGECAPS Sleep; Interest; Guilt; Energy; Concentration; Appetite; Psychomotor; Suicide
Manic mnemonic: DIGFAST Distractability; Indiscretion; Grandiosity; Flight of ideas; Activity increase; Sleep decrease; Talkativeness
Bipolar I vs II I can have hallucinations and mania where II is only up to hypomania
Difference in normal axiety from pathological anxiety is when the apprehension causes the individual significant distress and dysfunction
Difference in Dx of PTSD vs Acute Stress disorder PTSD 1 month or more; ASD minimum of 2 days max 4 weeks and occurs within 4 weeks of traumatic event
Main problem with extended use of benzos dependence
Be careful prescribing benzos to who and why? geriatric those with liver disease, low serum albumin, or obesity to avoid oversedation
4 toxicities of benzos sedative action, additive with alcohol, anterograde amnesia, 1st trimester teratogen
Problem with discontinuing alprazolam relapse of the condition or inability to discontinue
The long term use of chlordiazepoxide has never been investigated
Midazolam is used mainly for pre-op sedation, anxiolytic, and anteriograde amnesia
2 routes of midazolam administration IM, IV, oral
BuSpar treats persistent anxiety well but one downfall is it takes 2-4 weeks to work
BuSpar has been established as outPt therapy for GAD in which constant symptoms have been present for 1-12 months
Regular vs XR zolpidem causes what SE GI disturbances
Zaleplon can cause these complex sleep-related problems sleep driving, sleep eating, making phone calls
Created by: csheck