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13 Cards in this Set
- Front
- Back
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SUBSTANCE ABUSE DISORDERS 6
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1. Depression & Anxiety have a reciprocal relationship with substance abuse
2. Self medication 3. Agents causing most morbidity & mortality are legal: Alcohol & Tobacco 5. Screen everyone CAGE 6. Increasing anxiety most common symptom of withdrawal |
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5 Substance Abuse Common
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1. Self-medication
2. Substances themselves are depressants 3. Increasingly complicate patient’s lives 4. Issues of withdrawal 5. Aggravation of medical condition |
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CARDIOVASCULAR DISEASE with Anxiety & Depression: 3
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1. Increase morbidity & mortality following MI
2. Complicate effective control of hypertension 3. Clear relationship between Panic Disorder & cardiovascular mortality |
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RESPIRATORY DISEASE with Anxiety & Depression: 2
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1 Anxiety may trigger & prolong asthma attacks
2 Anxiety & Depression complicate the Management of Chronic Obstructive Pulmonary Disease |
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GASTROINTESTINAL DISEASE with Depression and Anxiety
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1 Effect both secretory function & motility of bowel
2 Complicate the management of most common GI problems: Irritable Bowel, Esophageal Spasm Syndrome & Peptic Ulcer Disease 3 Complicate the management of Crohn’s and Inflammatory Bowel Disease |
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DIABETES MELLITUS with Anxiety & Depression:
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Increase production of pituitary hormones
Increase catecholamine levels Suppress insulin secretion Relaxation training alone can reduce glucose levels in NIDDM Aerobic exercise extremely helpful in NIDDM |
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NONPHARMACOLOGIC TREATMENT METHODS for Anxiety & Depression:
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Patient education
Supportive psychotherapy Cognitive-behavioral therapy Relaxation training Biofeedback Osteopathic manipulative treatment Gradual elimination of caffeinated beverages Increasing levels of aerobic fitness Meditation |
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Mood Stabilizing Medications
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Lithium (in various forms) 0.5 meq. ----- 1 meq. ----- 1.5 meq./L.
Carbamazepine (Tegretol) (rapid cyclers) Valproic Acid (Depakene) Sodium Valproatic (Depakote) Clonazepam (Klonopin) |
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Early Signs of Lithium Toxicity
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Slurred speech
drowsiness muscle weakness tremor and twitching anorexia vomiting and diarrhea ataxia confusion |
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Late Signs of Lithium Toxicity
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impaired consciousness, stupor, confusion
hypertonic muscles and fasciculations increased deep tendon reflexes seizure coma death hyperextension in arms and legs |
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Newer Atypical Antidepressant Medications
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Bupropion (Wellbutrin)
Venlafaxine (Effexor) Nefazodone (Serzone) Mirtazapine (Remeron) Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) |
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Tricyclic Antidepressant
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Desipramine (Norpramin) Nortriptyline (Pamelor) Doxepin(Sinequan)
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SOMATIC TREATMENTS
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Electroconvulsive Therapy ECT
Vagal Nerve Pacing for rich people, it works Transcranial Magnetic Stimulation |
