click below
click below
Normal Size Small Size show me how
Psych 2 Antidepr
Antidepressants
Question | Answer |
---|---|
A pt presents with hyperphagia, hyperorality, and hypersexuality. What is the dx and what lesion caused it? | Kluver-Bucy syndrome. B/L amygdala lesion. |
What are the MCC of seizures in young adults (18-35yo)? | Trauma, EtOH withdrawl, Brain tumor |
What is the tx for cluster HA? | 100% O2 and ergotamines or triptans |
Name 4 characteristic features of serotonin syndrome. | 1. Mental status changes 2. Autonomic excitation 3. Neuromuscular hyperactivity 4. Ocular clonus (slow, contin horiz eye movements) |
What causes the hyperthermia in serotonin syndrome? How is it treated? | Muscle activity. Paralysis treats this; antipyretics will NOT work! |
If tachycardia or HTN need to be treated during serotonin syndrome, what 2 drugs should be used? | Either esmolol or nitroprusside (short-acting agents) |
If benzos don't calm agitation in serotonin syndrome, what drug can be used? | Cyproheptadine (serotonin antagonist) |
Name one SSRI and one SNRI that are known for causing serotonin withdrawal syndrome (flu-like sx) if stopped abruptly? | Paroxetine (SSRI) and venlafaxine (SNRI) |
What are the sx of overdose with TCAs? | cardiotoxicity, CNS toxicity, and anticholinergic sx |
If the QRS >100msec in case of TCA overdose, what drug should be given? | Sodium bicarb |
How should seizures in TCA overdose be managed? What drug should not be given? | GIve benzos, barbiturates, and/or propofol. Don't bother giving phenytoin b/c it's ineffective against this type of seizure |
How long must a pt expect to take an SSRI before they see improvement in their depression? | 3-4 weeks |
In TCA overodse, what can be used to correct the prolonged QRS interval and possible seizures? | Prolonged QRS: IV sodium bicarb Seizures: IV benzos |
Which antidepressant is preferred in the tx of depression with comorbid neuropathic pain? | Duloxetine |
In what group of pts is bupropion (Wellbutrin) contraindicated? | Pts with seizure disorder, eating disorders, or benzo or EtOH withdrawal. Bupropion lowers the seizure threshold. |
True or false. ECT (shock therapy) is safe for use in pregnant women. | True |
Which antidepressant matches the following statement?: SE priapism | Trazodone |
Which antidepressant matches the following statement?: lowers seizure threshold and can be used for smoking cessation | Bupropion |
Which antidepressant matches the following statement?: appetite stimulant that is likely to result in weight gain | Mirtazapine |
Which antidepressant matches the following statement?: works well with SSRIs and increases REM sleep | Trazodone |
Which antidepressant matches the following statement?: can be used for bedwetting in children | Imipramine |
What are the sx of serotonin syndrome? | Autonomic excitation, altered mental status, neuromusc hyperactivity, ocular clonus |
What are the sx of TCA overdose? | Cardiotox, CNS tox, anticholinergic sx |
What is the danger of starting SSRIs in adolescents? | May increase suicidal ideation |
What is the first line tx for depression with comorbid neuro pain? | SNRIs (eg venlafaxine, duloxetine) |
Which class of antidepressants can cause anticholinergic sx like dry mouth, constipation, and urinary retention? | TCAs (imipramine, amitriptyline, desipramine, nortriptyline) |
What can occur if a pt on an MAO-i eats tyramine-rich foods such as aged cheeses? | Hypertensive crisis |
Which antidepressant is indicated for depression with fatigue and difficulty concentrating or comorbid ADHD? Which problematic side effect is it notably missing? | Bupropion. No sexual side effects. |
What class of antidepressants should NOT be mixed with St. John's wort? | SSRIs. Also, it is only indicated for mild depression. Mod or severe depression should get SSRI instead. |