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96 Cards in this Set

  • Front
  • Back
What are some of the Comorbidities with Substance abuse?
• Anxiety, mood, antisocial personality, borderline personality, conduct disorders and schizophrenia
Name some long-term effects of alcohol abuse?
• Peripheral neuropathy
• Wernicke’s encephalopathy – acute, ataxia, confusion, ocular abnormalities (nystagmus).
• Korsakoff’s syndrome – chronic, irreversible, anterograde amnesia, confabulation, impaired recent memory
• Esophagitis
• Gastritits
• Mal-nutrition
• Fatty liver
• Alcoholic hepatitis
• Ascites
What does C.A.G.E. stand for? Used to screen for alcohol abuse
• Cut down
• Annoyed
• Guilty
• Eye-opener
What is given to alcoholics to prevent or reverse Wernicke’s encephalopathy?
Thiamine (Vitamin B1)
What neurotransmitters are imbalanced due to alcohol abuse?
GABA & Glutamate
What is Antabuse (Disulfiram) used for?
• Treatment of alcohol dependence in the maintenance phase
• Prevents liver from metabolizing alcohol
• Used to deter drinking – will cause bad reactions such as facial flushing, HA, vomiting, diaphoresis, dyspnea, chest pain. Patient’s will still have desire and cravings.
• Cant use anything with alcohol in it – mouthwash, cough syrup
• BAL (blood alcohol level) must be 0 before administering
Besides Antabuse (Disulfiram) – what other medications can be used to treatment alcohol dependence?
• Revia (Naltrexone) – reduces desire/cravings (black box warning –hepatotoxicity)

• Campral (Acamprosate) – restores GABA/Glutamate balance, monitor for suicidal thinking/depression, can cause renal impairment
What is given to patients during alcohol detoxification to help with withdrawal symptoms?
• BZD – Librium/Ativan (to decrease withdrawal symptoms)
• Anticonvulsants (for seizures0
• Propranolol (for tremors)
• Multivitamin and folic acid
• Thiamine (B1) – (to prevent Wernicke’s encephalopathy
• CIWA – clinical instrument of withdrawal assessment
What neurotransmitter is associated with addiction (pleasure center)?
Dopamine (e.g. opioids)
What is the treatment for an opiate overdose?
• Narcan (Naloxone) – v-fib, sz, MI
• Revex (Nalmefene) - arrthymias, sz
How can you tell if someone is using opiates? (think RAM)
• Resp. depression
• Altered mental status
• Miosis (constricted pupils)
What is the often the first sign of opiod withdrawal?
Dilated pupils and anxiety
The “runnys” are associated with __opioid__ withdrawal
Diarrhea, rhinorrhea, lacrimation, diaphoresis, salivation
What are some side effects of amphetamines?
Weight loss, insomnia, nervousness, parnoia, psychosis, arrthythmia/HF
(increase energy, HR)
Common symptoms of Methamphetamines are ___________ and ___________
insomnia, irritablity, aggressive behavior
What is the most successful treatment of opiate detoxification?
Which drug is used to treat opiate withdrawal (after detox)?
Naltrexone (Revia)
Cocaine blocks ______ reuptake
1 cup of coffee = mg?
150 mg caffiene
What are some L/T side effects of hallicuinogens?
Flashbacks - can occurs days, months, years after using drugs (e.g. cocaine)
How much caffiene would cause tinnitus, severe agitation, arrhythmias?
6 cups coffee or 1000 mg of caffiene
What should be avoided during hallucinogen flashback treatment?

(may make it worse)
PCP intoxication if a psychiatric _________

Potential for extreme violence and psychosis
What are some side effects of steroid use?
Mania, depression, suicide
delusions, rage, mood swings
"Sudden sniffing death" is related to what substance?
- causes death by suffocation

(e.g. glue, Lysol)
Name some 'date rape' drugs?
Rohypnol (Flunitrazepam)

Memory loss, antergrade amnesia
What is considered one of the most lethal substances in society?
Why is it difficult to prove that someone has been given a date rape drug? (GHB-gamma hydroxybutyrate)
Take effect in 10 minutes and clears system in 2 hours. No tests available to detect.
What can be used to treat nitotine addiction?
Zyban (bupropion)
Clonidine (Catpres)
Name some risk factors for psychiatric disorders in childhood and adolescence
Severe mental discord
Low socioeconomic status
Large families (overcrowding)
Parental criminality
** Maternal psychiatric disorders**
Foster care placement
What can traumatic life events during childhood and adolescence lead to ?
Insure attachments
Conduct disorders
Impaired social/cognitive function
Depression/suicidal behaviors
Abused children are at risk for _______ disorder
Dissociative identity disorder

(use to be called multiple personality disorder)
What are some the presenting symptoms of Autism?
Impaired in communication and imaginative activity (e.g. language delay/absence, pronoun reversal, singsong speech, lack of spont. make-believe play, inability name objects)

Impairment in social interactions (e.g. no eye contact/facial expression, aversion physical contact, failure to dev. peer relationships)
What medications are used for Autistic Disorder?
Propranolol (Inderal)
Clomipramine (Anafranil)
What part of the brain is effected with Autism?
Left sided (controls language, logic, reasoning)
What developmental disorder is only seen in females?
Rhett syndrome
What is the difference between Asperger's syndrome vs Austism?
Austism - before 3 yrs
Asperger's - school age, no significant delays cognitive/language, Age approp self-help skills, but impaired social interactions, like repetitive behavior/activities (think RAIN MAN)
What are some characteristics of ADHD?
What is Childhood Disintegrative Discorder?
Loss of skills (either communication, social, motor, b/b control) after at least 2 years of normal functioning
What are some co-morbidities of ADHD?
Oppositional Defiant Disorder
Conduct disorder
Mood disorders
Tourette's disorder
The drug of choice for ADHD is ?
What is Oppositional Defiant Disorder?
Recurrent - negatisvistic, disobedient, hostile, defiant behaviors toward authority figures
What are the characterists of Oppositional Defiant Disorder (must be present 6 months or more)?
Loses temper
Argues w/ adults
Blames others
Annoyed, angry, spiteful
Is childhood onset Conduct Disorder associated with physical aggression?

They violate the rights of others - often using violence - under age 10
Conduct disorders frequently lead to _________ Disorder.
Adult Anti-social Disorder
What are some predisposing factors for Conduct Disorders?
Inconsistent parenting with harsh discipline
Early institutional living
Associated w/ delinquent peer group
What is separation anxiety?
When a child become excessive anxious when separated or anticipates separation from home or parental figure
What is the pharmacolgical treatment for Conduct/Oppositional Defiant Disorder?
Anti-anxiety agents (diazepam, alprazalom, librium) - s/t use
Name some medications for Tourette's syndrome?
Haldol -if severe
Pimozide (Orap) - no kids under 12
Clonidine (Catapres) - drug of choice
What are some types of somatization disorders?
Conversion disorder
Sleep disorder
Body Dysmorphic disorder
Pain disorder
What is somatization?
The expression of phycholical stress through physical symptoms (not intentional)
Whis disorder is associated with "doctor shopping"?
Pain disorder
What is 'conversion disorder'?
loss or change in body function - that is not present - they only think it is. (think 'Taladelga Nights')
Which disorder is associated with history of life-threatening illness to self or significant other?
Body Dysmorphic disorder is a co-morbidity of _______
Give an example of a pseudoneurological symptom.
Difficulty swallowing 'lump in throat'
Double vision
Loss of touch/pain sensation
What is narcolepsy?
excessive sleep
What is Body Dysmorphic disorder?
Preoccupation with imagined defect in appearance (e.g. facial flaws)
What medication(s) used to treat insomnia?
Lunesta (luna = moon)
What drug can be used to treat narcolepsy?
Stimulant drugs-

What is a common co-morbidity of alcohol abuse?
What are the first line drugs for treatment of Major Depression Disorder?

(Zoloft, Paxil, Lexapro, Prozac, Luvox, Celexa)
What is dysthymia?
chronic low level depression
Can Serotonin Syndrome be fetal?
What are the neurotransmitters that are low/decreased in depression?
HANDS - 4 up 1 down
Histamine - down
Acetylcholine - up
Norephinephrine - down
Dopamine - down
Sentonin - down
What is a high priority question to ask a depressed patient?
suicidal ideation
Which drug can be used for mild to moderate depression mixed with anxiety?
Which neurotransmitters are increased in Bipolar -mania?
What are some co-morbidities of Bipolar Disorder?
Substance abuse (increases risk of suicide)
Anorexia nervosa (incrase risk of suicide)
Anxiety/personality disorders
What are some disturbances in thought processes?
Rapid speech
Grandiose delusions
Flight of ideas
What is the drug of choice for Bipolar disorder?
How often should lithium serum levels be drawn after the last dose?
12 hours
Name an anticonvulsant used to treat Bipolar Disorder?
Carbamazepine (Tegretol)
What is the maintance level of Lithium?

Acute mania?
0.4 - 1.0 mEq/L

1.0 - 1.5 mEq/L
What are the expected side effects of lithium (at the therapeutic level)?
Fine hand tremors
Mild nausea
Weight gain
What is a serious side effect of Carbamazepine (Tegretol)? (anti-convulsant to treat bipolar)
blood dyscrasias

agranulocytosis & aplastic anemia
Why are tri-cyclic antidepressants contraindicated in treatment of bipolar depression?
Due to the risk of increase mania, increase suicide attempts
What are the preferred antidepressants for bipolar depression?
What are med's used to treat anxiety in bipolar disorders?
PAM has anxiety

What are some positive (+) symptoms of schizophrenia?
Bizarre behavior
Formal thought disorder
What are some negative (-) symptoms of schizophrenia?
Affective blunting
Anergia (lack of energy)
Anhedonia (no pleasure in life)
Poverty of ideas/content of speech
Thought blocking
Which type of drugs treat the positive symptoms of schizophrenia?
Typical anti-psychotics
Which type of drugs treat the negative and positive symptoms of schizphrenia?
Atypical (2nd generation)
What are some common delusions in schizophrenia?
Thought broadcasting
Thought insertion
Thought withdrawal (brainwashing)
Which type of hallicination is most common in schizophrenia?
What are some common side effects of traditional anti-psychotics (schizophrenia)
NMS (neuroleptic maligant syndrome)
Name some examples of pseudoparkinsonism?
Pill rolling
shuffle gait
Mask like facies
What is NMS?
Life threatening emergency Hypodopaminergic crisis
What are the s/s of NMS?
CPK elevated
Autonomic instability (tachy)
Mental status changes
What is EPS?
Extrapyramidal Symptoms

Tardive dyskinesia (abnormal, invol. movement)
What is the drug of choice for treating NMS?
"A Ghose Really Can See Zebras" is a way to remember some atypical antipsychotics. Name these.
How do your treat EPS symptoms?

Why do atypcial antipsychotic drugs have a black label warning for the elderly with dementia?
Due to death from CV or diabetic complications
Name some types of schizophrenia?
Paranoia -reponsive to tx, auditory hallucinations

Disorganized - most regressed/socially impaired, only able to live in structured and well-supervised setting
Which schizophrenia is associated with 'waxy flexibilty'?

Often echoes words others say