Psych 1
Help!
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| How long does normal bereavement last? | PERIODICALLY for 6 months. Does NOT impair ability to function. (2wks continuously after 2m is considered depression)
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| Neurotransmitter change in: Anxiety d/o? | increased NE, low 5HT, low GABA
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| Neurotransmitter change in: Depression? | low NE, low 5HT, low DA
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| Neurotransmitter change in: Mania? | high NE, high 5HT
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| Neurotransmitter change in: Alzheimer's? | low ACh
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| Neurotransmitter change in: Huntington's? | low ACh, low GABA
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| Neurotransmitter change in: Schizophrenia? | high DA
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| Neurotransmitter change in: Parkinsons? | low DA, high ACh
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| After how long can Major Depressive Disorder be diagnosed? | 2 weeks w/ functional impairment
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| What medical conditions can cause depression? list of 6. | hypothyroidism, hyperparathyroidism, Parkinsonism, ACA stroke, CNS neoplasm, Pancreatic Ca
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| What anti-HTN drug can cause depression? | methyl-DOPA
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| Haloperidol (1st gen antipsychotic) can cause ____________ | Depression
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| What antiviral can cause depression? | a-IFN
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| T/F glucocorticoids can cause depression. | True
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| What antineausea drugs can cause depression | metoclopramide, prochlorperazine
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| What's the difference between Major Depressive Disorder w/ Psychosis and Schizoaffective Disorder? | MDD w/Psychosis = Depression always present, psychosis comes and goes. Schizoaffective = Psychosis always present, depression comes and goes
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| What does SIG E CAPS stand for? | Sx of Major Dep d/o: Sleep disturbance, Interest loss, Guilt, Energy reduction, Concentration impaired, Appetite changes, Psychomotor change, Suicidal ideas
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| What are the Sx of atypical depression? | hyperphagia, hypersomnia, hypersensitivity to rejection, leaden paralysis
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| Which is better for treating atypical depression: MAOi or TCA? | MAOi
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| First line Rx for seasonal affective disorder? | light therapy + SSRIs/bupropion
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| Name 6 SSRIs | Fluvoxamine, fluoxetine, sertraline, paroxetine, citalopram, escitalopram
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| What drug group do these belong to: Imipramine, amytriptaline, desipramine, nortrypitaline, clomipramine, doxepine | TCAs
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| The 3 MAOi's are? | Fenalzine, Tranylcypromine, selegiline
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| Bupropion is what drug class? | NDRI
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| What drug class are venlafaxine, duloxetine, milnacipran, nefazodone | SDRI
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| What are teh 2 tetracyclics | mertazapine, trazadone
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| What drugs, combine with SSRIs, can cause serotonin syndrome? | other SSRIs, MAOi's, SNRIs, along with: St Johns Wort, tryptophan, illegal drugs (cocaine, amphetamines), L-DOPA
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| What eye signs are present in serotonin syndrome? | ocular clonus (slow horizontal movements
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| If a pt is suffering from serotonin syndrome, and is agitated in spite of benzos given, what's the next step? | Give anti-serotonin agent (ciproheptadine)
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| SSRI withdrawal syndrome consists of what symptoms? What 2 SSRI's are nototious for it? | dizzy, nausea, fatigue, chills, anxiety. Paroxetine, venlofaxine are the worst offenders.
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| How do you treat SSRI withdrawal syndrome? | fluoexitine (long acting SSRI)
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| Children who are to be put on TCAs should be screened for _________ abnormalities. | Cardiac (arrhythmias, syncope, etc)
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| Mild depression is called ________. What is the Rx? | Dysthymic disorder. Rx = psychotherapy (SSRIs if that doesn't work)
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| 3 s/e's of TCAs? | cardiotoxic, neurotoxic, anticholinergic symptoms
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| First line Rx for depression and anxiety? | SSRIs
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| SSRIs require ______wks to take effect. | 3-4 wks.
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| s/e of SSRIs include? | sex dysfxn, suicidal in adolescents, low platelets
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| What's first line Rx for depression w/ neurologic pain? | SNRIs
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| What do you give after ABCs in TCA overdose? | charcoal. gastric lavage if w/i 2hrs of ingestion.
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| How do you treat QRS prolongation of TCA overdose? | Sodium bicarb trial, then infusion if effective
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| Depression with fatigue and ADHD is treated with ______________. | Bupropion
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| Bupropion is avoided in patients with _____(2)_______ disorders, or taking ______(2)_________ | eating disorder, seizure disorder, coming off EtOH or MAOi
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| Psychotic depression is treated with _____________. | electro convulsive therapy
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| Depression with catatonic stupor is treated with ________________. | ECT
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| Why is electroconvulsive therapy given to patients with severe suicidal ideation? | Because drugs take 3-4w
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| What's the difference between manic and hypomanic episode? | manic = >1wk, interferes with normal fxning. hypomanic = 3d+, no impairment. (bipolar II is hypomanic)
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| What are the first line drugs for bipolar disorder? (3) | lithium, carbamezapine, valproate
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| Rapid cycling bipolar is treated with which 2 of the 3 typical Rx? | carbamezapine, valproate
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| What specific kidney problem can lithium cause? | Nephrogenic diabetes insipidus
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| True/False: you should add an antidepressant to mood stabilizers during depressive stage of bipolar d/o. | False: no added benefit of giving anti depressants. It's better to add another mood stabilizer or antipsychotic. ECT if very severe depression
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| Adjustment disorder has the same causes as major depressive disorder, except for ___________. | Bereavement.
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| Adjustment disorder begins _______months after stressor, and is usually releived within ____months of onset. | 3months, 6 months
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| How do you treat adjustment disorder? | psychotherapy
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| Cyclothymic disorder is a mild form of ______________. It must last _____. | Bipolar disorder. (rapid cycling of mild depression and hypomanic episodes for >2y)
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