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22 Cards in this Set
- Front
- Back
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Clinical Guidelines for Prescribing Psychotropic Drugs. The 5 D’s
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Diagnose
drug selection dosage duration dialogue |
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what are only antipsychotic drugs you can use in children?
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FDA approved only. no off label use.
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what do you do when dosing an elderly person?
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half the recommended dose
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what is the problem with antipsychoitics and prego?
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all cross the placenta and into the milk. try to avoid in the first trimester and in nursing.
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serotonin syndrome
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presents like malignant hyperthermia and occurs when someone takes to many drugs that increase the serotonin levels.
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SSRI Discontinuation Syndrome
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this is when someone is pulled off an SSRI abruptly. more common with the SSRI with short half lives. these ppl present with dizzyness, weakness, NV, insomnia. this is self limiting and not fatal.
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Neuroleptic Malignant Syndrome
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this is an AE to a neuroleptic drug. see increase in CPK and present like malignant hyperthermia.
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tx for NMS
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stop meds, cooling blankets, IV fluids, NSAIDS
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Extra Pyramidal Symptoms includes...
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parkinsonism, akathisia, dystonia.
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A severe form of restlessness associated with a compulsion to move..
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akathesia
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Spasms or muscle stiffness usually most prominent in head and neck, which occur early in the course of treatment or with dose increases – muscle stiffness, eye fixation, torticollis, and throat
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dystonia
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A collective term for a set of late-onset and sometimes irreversible disorders which can include chorea, dysphonia, dystonia, tics, and myoclonus. The tongue panting.
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tardive dyskanesia
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pro to the use of electroconvulsive therapy (ECT)
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ECT is effective
Most effective treatment for mood disorders Major depression 80-90% efficacy Bipolar mania ~ 80% efficacy ECT is safe Mortality rate extremely low, 0.01% ECT may have more rapid response 2-4 weeks to remission ECT is generally well tolerated |
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what are some common indications for ECT
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bipolar, depression, mood disorders in prego, schizo
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what are the contraindications to ECT
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increased intracranial press, intracranial lesion, extreme HTN, allergies to anesthetics, seizures, fracture of the spine.
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what is the MOA of ECT
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Induce seizure (similar to insulin shock therapy)
Causes outpouring of neutrotransmitters and the rest is for conjecture |
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which is more effective: unilateral or bilateral ECT
which has more AE |
bilateral
bilateral |
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what are some AE to ECT
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memory loss, headache, delirium
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what is the length of tx for ECT
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1-12 tx up to 3x per week
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when would you use phototherapy?
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seasonal depression, sleep disorders, OCD with seasonal component.
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when do you resort to neurosurgery?
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last resort. when nothing else worked.
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what is a tx regiment for refractory OCD?
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deep brain stimulation
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