Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
Major Depression defined
|
lasting 2 or more weeks
5/8 symptoms fatigue change in wgt appetite dysphoria or apathy in/hypersomnia worthless/guilty, inability to make decision, suicide ideation |
|
|
Dysthymic disorder defined
|
depressed mood for two or more years, at lease two sypmtoms
change in appetitie, in/hypersomnia. fatigue, poor concentration, decision difficulty, hopeless |
|
|
adjustment disorder defined
|
must have a identifiable event. difficulty adjusting, symptoms occure within 3 months of event.
acute less than 6 months duration depressed, hopeless, tearfull chronic greater than 6 months |
|
|
Medical conditions associated with depression
|
mi, ca, ms, hiv, cva, iddm parkinsons
|
|
|
diagnostic labs to abtain when questioning depression diagnosis
|
cbc w diff
lytes, rft, lft, glucose, tsh, b12, tox screen |
|
|
A screening tool for depression
|
SIG E CAPS
sleep, intersts, guilt, energy concentration, appetitie, psychomotor suicidality |
|
|
What are three other screening tools besides the sig e caps
|
zung self rating
beck depression inventory CES-D |
|
|
risk factors for suicide
|
sad person
sex , age, depression, previous attempts,ETOH, rational thinking decline, social support absent, organized plan, no significant other, sickness |
|
|
what are some suicide interventions
|
identify/reestablish social network
relieve isolation remove lethal weapons encourage expression of anger no final decisions during crises only give 2-3 days of medication with f/u plan |
|
|
The objectives of depression management are
|
ensure safety
control symptoms restore functioning |
|
|
Principles of pharmacologic management
|
Identify target symptoms
effect takes 4-6 weeks treat for 8- 12 months minimum start low titrate up watch for drug drug interactions |
|
|
What are the advantages of tca's and an example of one
|
Imipramine.
low cost, qd dosing, good efficacy, good for adjucntive tx for chronic pain. |
|
|
Disadvantages of TCA's
|
SE: sedation, htn, anticholinergic
Drug interactions hypomania |
|
|
Describe SSRIs
|
Paxil, Celexa, Zoloft, lexapro, prozac
first choice, safety in overdose, can start at theraputic dose, tolerability, |
|
|
SSRI side effects include
|
nausea, agitation, sexual dysfunction,
serotonin syndrome: flu-like myalgias, anxiety, irritability, insomnia, |
|
|
SARI's examples and effects
|
Trazadone, sezone,
wide theraputic index improves sleep minimal sexual effects * risk of priapism |
|
|
SSARB example and effects
|
remeron
safety in overdose no GI or sexual effect decrease anxiety, improves sleep, adverse,, am sleepy, wght gain. |
|
|
anxiety is pathological if
|
diaproportionate
sustained over time impairs functioning unrelated to identifiable event |
|
|
Generalized anxiety disorder characteristics
|
excessive worry
lasting 6 months or more interferes with functioning |
|
|
characteristics of Panic Disorder
|
Discrete episodes
no prodrome, sudden onset, peak intensity about 10 min. paresthesias, shills. glushes. sob. cp, nausea |
|
|
assessment of anxiety disorder includes
|
muscle aches, fatigue, rapid speech, hand wringing, tense, anxious, worried, goal directed, forgetful, indecisive, limited insight.
Labs. cbc w diff, chemistry, tsh b12, tox screen |
|
|
Screening tool for axiety disorder
|
Becks anxiety inventory at baseline and periodically
|
|
|
NOn-pharmocologic treatment of anxiety disorder
|
behvior therapy
systemic desensittization exposure therapy relaxation therapies biofeedback cog-behav therapy interpersonal therapy self help groups |
|
|
pharmacological management of anxiety disorders inclde
|
Benxodiazepines;never xanax
Nonbenzodiazapines.. buspar SSRI Paxil Zoloft First line for chronic anxiety |
|
|
what is the mnemonic for mania
|
SIG DAM PT
sleep, irritability, grandiosity, distractability, appetite, mood, psychomotor, talkative |
