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29 Cards in this Set
- Front
- Back
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ADHD Tx
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1st line: methylphenidate and dextroamphetamine
2nd line: atomoxetine- chosen over 1st line bc fewer S.E.s |
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Tx for pt. with depression and neuropathic pain
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desvenlafaxine
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pt. w/ depression who is fearful of wt gain or sex SEs
or trying ot quit smoking |
bupropion
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Bipolar with:
-compromised kidneys -exhibiting mania, has been noncompliant w/ meds |
-don't use Li
-give Antipsychotic |
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Atypical depression
-what is it? -Tx |
->ed sleep, >ed wt., >ed appetite
-pick SSRI b4 MAOI |
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Valproic acid adverse affects
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must monitor levels to prevent toxicity,
toxicity -> hyponatremia, coma, death |
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serotonin syndrome Tx
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-stop SSRI
-symptomatic Tx of fever, diarrhea, HTN -give cyproheptadine (5HT antagonist) |
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schizo tx:
-in ermergency situation if need IM -if noncompliant -not responding to Tx |
-olanzapine, ziprazidone
-long acting (like rispseridone or haloperidol) -clozapine, never 1st line |
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Olanzapine SE
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greater incidence of DM and wt. gain.
avoid in diabetic and obese pt. |
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Risperidone SE
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greater incidence of movement disorders
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quetiapine SE
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less movement disorder than risperidone
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clozapine
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agranulocytosis (drugs causeing agranulocytosis: ticlopidine, colchicine, carbamazapine, clozapine, PTU/methimazole, Dapsone)
-monitor WBCs regularly, never 1st line bc. of SE |
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Mngmt of adverse effects of antipsychotic meds
acute dystonia: -onset of symptoms -symptoms -Tx |
-4 hours
-muscle spasms (ex. torticollis), laryngeal spasms, occulogyric crisis -benztropine, diphenhydramine, trihexphenidyl |
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Mngmt of adverse effects of antipsychotic meds:
akathisia -onset of symptoms -symptoms -Tx |
-weeks
-generalized restlessness, pacing , rocking, can't relax -reduce dose, beta blocker, switch to atypical |
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Mngmt of adverse effects of antipsychotic meds:
tardive dyskinesia -onset of symptoms -symptoms -Tx |
-rare b4 6 mos
-abnormal invol mvmnt of head, limb, trunk. perioral movements most common -switch to atypical, CLOZAPINE has least risk |
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Mngmt of adverse effects of antipsychotic meds:
Neuroleptic malignant syndrome -onset of symptoms -symptoms -Tx |
-not time limited
-muscular rigidity, fever, autonomic changes, obundation -Dantrolene or bromocriptine |
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1st line tx for panic disorder?
panic attack? |
-SSRI
-benzo ex alprazolam |
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OCD Tx
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1st SSRI
2nd TCA if compounded with psychosis then Olanzipine |
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PTSD and acute stress disorder TX
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paroxetine and sertraline
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ROH w/drawal
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chlordiazepoxide, oxazepam
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Antianxiety for emergency situation
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Lorazepam bc. can be given IM
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when is flumazenil used as a benzo antagonist?
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-overdose is acute
-you are certain there is no chronic dependence (bc flumazenil can cause seizures in benzo dependent pt.s) |
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opiates
-Tx of intox -Tx of w/drawal |
-naloxone
-clonidine, mehtadone, or buprenorphine |
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narcolepsy tx
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forced naps and modafinil
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Tx of Tourette's syndrome
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fluphenazine, pimozide, or tetrabenazine
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steps for tx of acute mania
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1. hospitalized
2. stabilized with antipsychotics 3. long term maintenance therapy: 1st line: lithium, lamotrigine, olanzapine, or quetipine 2nd line: valproic acid or aripiprazole |
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Tx of acute dystonia from antipsychotic:
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antihistamine (diphenhydramine) or anticholinergics (benztropine or trihexyphenidyl)
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OCD tx
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SSRI 1st line- paroxetine, 2nd- clomipraine (TCA).
OCD + psychotic features = olanzapine |
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Alzheimer's tx
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donepezil, rivastigmine, galantamine, or tacrine
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