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Psych 2 Antidepr

Antidepressants

QuestionAnswer
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.
Created by: sarah3148