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283 Cards in this Set

  • Front
  • Back
Order of meds given in pt with AMS and + BAL
Thiamine always BEFORE glucose, or can precipitate Wernicke-Korsakoff syndrome (b/c is a coenzyme used in carb metabolism)
3 topographic theories of psychotherapy
Unconscious, preconscious, conscious
3 structural theories of psychotherapy
Id, ego, supergo
Normal development of egos
Id at birth, ego present after birth, superego by 6yo
What is used to control instinctual urges in the ego?
Defense mechanisms
What is used to detect fantasies/ psychoses in the ego?
Reality testing
4 mature defense mechanisms
Altruism, humor, sublimation, suppression
7 neurotic defense mechanisms
Controlling, displacement, intellectualization, isolation of affect, rationalization, reaction formation, repression
What is displacement and what is an example?
Shifting emotions from an undesirable situation to one that is personally tolerable (student who is angry at his mom talks back to his teacher the next day and refuses to obey her)
What is reaction formation and what is an example?
Doing the opposite of an unacceptable impulse (man in love w/ his coworker insults her)
% of incarcerated patients who have antisocial PD?
80%
Difference btwn repression and suppression
Former is unconscious
4 immature defenses
Acting out, denial, regression, projection
What is acting out and what is an example?
Giving in to an impulse, even if socially inappropriate, to avoid the anxiety of suppressing it (man who is told his therapist is going on vacation "forgets" his last appt)
What is projection and what is an example?
Attributing objectionable thoughts or emotions to others (husband attracted to other women believes his wife is having an affair)
2 other defense mechanisms
Splitting and undoing
What is undoing and what is an example?
Attempting to reverse a situation by adopting a new behavior (man who briefly fantasizes about killing his wife by sabotaging her car takes the car in for a complete check-up)
Goal of psychoanalysis
Resolve unconscious conflicts by bringing repressed experiences/ feelings into awareness
Psychoanalysis is ____ oriented
Insight oriented
5 behavioral therapy techniques for deconditioning
Systemic desensitization, flooding and implosion, aversion therapy, token economy, biofeedback
Which technique is used in both systemic desensitization and flooding/implosion
Relaxation techniques
Difference between flooding and implosion
Real vs. imagined, respectively
Foundation of cognitive therapy
Identify and replace maladaptive thoughts w/ positive thoughts
2 common problems addressed in family therapy
Boundaries that are too permeable
Triangles (2 people forming an alliance against a 3rd)
4 types of marital therapy
Conjoint therapy, concurrent therapy (separate but same therapist), collaborative (seen individually), four-way therapy (2 therapists, common for sexual problems)
4 topics taught in DBT
Mindfulness, interpersonal effectiveness
How does cocaine cause its stimulant/reward effect?
Blocks dopamine reuptake
3 ways cocaine overdose can cause death
Arrhythmia, seizure, respiratory depression
Cause of MI/CVA in cocaine user
Vasoconstriction
Cocaine intoxication mimics
Flight or fight (sympathomimetic)
Ddx for cocaine intoxication
Amphetamines or PCP
Sedative withdrawal
How long will urine tox be positive for cocaine?
3 days (longer in heavy users
Rx for cocaine intoxication
Benzos (+ haloperidol for severe agitation/psychosis)
Rx for cocaine dependence
TCAs or dopamine agonists (amantadine, bromocriptine)
Risk of cocaine withdrawal
Really nothing: terrible crash, but not life-threatening
3 classic and 2 designer amphetamines
Dextroamphetamine (Dexedrine)
Methylphenidate (Ritalin)
Methamphetamine

MDMA (ecstasy)
MDEA (eve)
Difference between classic and designer amphetamines
Designer release serotonin (in addition to dopamine) and have hallucinogenic properties (in addition to stimulant)
How long will urine tox be positive for amphetamines
1-2 days (though many tests aren't sensitive enough)
Rx for amphetamine intox/dependence/withdrawal
All same as cocaine
Rotatory nystagmus
PCP intoxication
Which drug intoxication is most likely to cause violence
PCP
Which drug is most similar to PCP?
Ketamine
Mechanism and effect of PCP
NMDA glutamate antagonist (and dopamine activator) --> hallucinogen
Risk of PCP overdose
Seizures, coma
5 components of PCP Rx
1) Benzos or dopamine antagonists to control agitation/anxiety
2) Diazepam for spasms/seizures
3) Acidify urine w/ ammonium chloride and ascorbic acid
4) Haloperidol for severe agitation/psychosis
5) Monitor BP, temp, lytes
Ddx for PCP intoxication
Psychosis, schizophrenia
How long is a urine tox screen positive for PCP?
>1 wk
Which lab values are often elevated in PCP use?
CPK and AST
Does PCP have withdrawal symptoms
No, but pts may have flashbacks
How do benzos and barbiturates work
Potentiate GABA by increasing the frequency or duration (respectively) of chloride channel opening
Complication of benzo or barbiturate abuse
Respiratory depression
How long is a urine tox screen positive for sedatives?
1 wk
Rx for sedative overdose
Activated charcoal to prevent further absorption
Rx for benzo overdose
Flumazenil (antagonist)
Risk w/ flumazenil
Seizures
Rx for barbiturate overdose
Alkalinize urine w/ sodium bicrb to promote renal excretion
Withdrawal from sedatives
Autonomic hyperactivity, risk of life-threatening seizures
Rx for sedative withdrawal (2)
Long-acting benzo (diazepam) and valproic acid for seizures
How long is a urine tox screen positive for opiates?
12-36hrs
Triad of opioid overdose
Respiratory depression, AMS, miosis
Which opioid produces midriasis instead of miosis?
Meperidine (Demerol)
Rx for opioid withdrawal
Clonidine or buprenorphne; methadone if severe
3 hallucinogens
Mushrooms (psilocybin), mescaline, LSD
Hallucinogens don't cause
Physical dependence or withdrawal
Rx for hallucinogen intoxication
Usually just talking down pt
Use of marijuana in cancer/AIDS pts
Anti-emetic and appetite stimulant, respectively
How long is a urine tox screen positive for marijuana?
4 wks (released from adipose stores)
Inhalants are CNS ___?
Depressants
Risk w/ inhalant overdose
Respiratory depression or arrhythmias
Long-term inhalant use can damage
CNS, PNS, liver, kidney, muscle
How long is a urine tox screen positive for inhalants?
4-10hrs
Mechanism of caffeine (2)
Adenosine antagonist, so increases cAMP

Stimulant via dopaminergic effects
Caffeine intake >1 gram can cause
Tinnitus, agitation, arrhythmias
Caffeine intake >10grams can cause
Seizures or respiratory failure --> death
Neurotransmitter involved in nicotine addition
Dopamine
What is pseudodementia?
Depression in elderly --> decrease in memory and cognitive functioning
Difference btwn demented and pseudodemented pts when they don't know an answer
Demented pts confabulate
Depressed pts say "I don't know"
Sundowning is more common w/
Dementia
2 good antidepressants in elderly
SSRIs and mirtazapine
Major antidepressive side effect in elderly
Anticholinergic
Abnormal guilt may involve (3)
Hallucinations or delusions

Suicidal ideation

Duration >1yr
Sleep cycle changes in elderly (3)
Increase number of REM cycles (but no change in total duration)

Increase in Stage 1 and 2 sleep

Decrease in Stage 3 and 4 sleep
Prevalence of elder abuse
10% of pts >65yo
Baseline kidney function should be assessed in pts starting which mood stabilizer?
Lithium
Baseline EKG is required in pts starting which antipsychotic?
Ziprasidone (Geodon)
Manic presentation could be due two which two substances?
Cocaine or amphetamines
4 problems commonly associated w/ panic disorder
Depression
Aographobia
GAD
Substance abuse
How long should the intense grieving of bereavement last?
<2mo
CT scan of schizophrenic pt
Enlarged ventricles and prominent sulci
Hyperthermia, autonomic instability, muscular rigidity, altered sensorium
Neuroleptic malignant syndrome
Which drugs cause neuroleptic malignant syndrome?
Antipsychotics (dopamine antagonists)
Complication of neuroleptic malignant syndrome
Rhabdomyolysis (--> myoglobinuria --> ARF)
Rx for NMS
Dantrolene (muscle relaxant)
Dopamine agonists (bromocriptine/ amantadine)
D/c responsible drug
Supportive (fluids, cooling, alkaline diuresis)
What drugs can be used in lieu of antidepressants for MDD and in what scenario?
Psychostimulants (e.g. methylphenidate or modafinil)

Short life expectancy (before onset of efficacy of SSRI, for example)
Rx for panic attack/ panic disorder (2)
Benzos (e.g. alprazolam) for acute attack

SSRI for long-term prevention
4 dissociative disorders
Dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization disorder
Another name for dissociative identity disorder?
Multiple personality disorder
Amnesia due to a stressful life event
Dissociative amnesia
When do pts w/ dissociative amnesia return to normal?
Minutes or days
Rx for dissociative amnesia (and dissociative disorders in general)
Hypnosis or Ativan during interview to help patient talk freely (retrieve lost memories)
What is abreaction?
Strong reaction when retrieving traumatic memories
Sudden travel away from home in which a person takes on a new identity and can't remember the past
Dissociative fugue
Difference in the amnesia between dissociative amnesia and dissociative fugue
In dissociative amnesia, pts are aware they've forgotten something
Prognosis of dissociative fugue
Hours to days or longer; afterwards pt will resume old identity and not remember fugue
Most dissociative identity disorders pts are
Women who have experienced prior trauma
Suicide rate for dissociative identity disorder
30%
What is dissociative identity disorder?
2 or more identities that take control of behaviors/ thoughts; unaware of events during prior personality states
Symptoms of dissociative identity disorder are similar to those of?
Borderline personality disorder
Persistent/ recurrent episodes of being detached from one's body or mind (like an outside observer) but w/ reality testing intact
Depersonalization disorder
Depersonalization disorder has a high comorbidity with
Anxiety/ panic
Rx for depersonalization disorder
Anti-anxiety meds or SSRIs for anxiety symptoms
What is primary gain?
Expression of unacceptable feelings as physical symptoms to avoid facing them
DSM criteria for somatization disorder
2 GI, 1 sexual, 1 neuro, and 4 pain symptoms + onset before age 30
Comorbidities w/ body dysmorphic disorder
90% depression, 70% anxiety, 30% psychosis
Rx for body dysmorphic disorder
SSRIs, no procedures
Two types of pain disorder
Acute (<6mo) or chronic (>6mo)
Ddx for pain disorder
Hypochondriasis or malingering
What must be ruled out w/ all somatoform disorders
Hypochondriasis and malingering
Intentionally producing medical or psychological symptoms to assume role of sick pt
Factitious disorder
Difference factitious disorder and malingering?
Factitious disorder involves primary gain

Malingering involves secondary gain
Commonly feigned symptoms in factitious disorder
Hallucinations, depression, fever, abdominal pain, seizures, skin lesions, hematuria
Factitious disorder w/ predominantly physical symptoms
Munchhausen syndrome
Common history of pts with factitious disorder
Child abuse or neglect
Failure to resist aggressive impulses --> assault or property destruction
Intermittent explosive disorder
Aggressiveness is associated w/ this neurotransmitter (low or high?)
Low serotonin
Rx for intermittent explosive disorder
SSRIs, anticonvulsants, lithium, propanolol
Which therapy technique often fails in intermittent explosive disorder?
Individual therapy
5 impulse control disorders
Intermittent explosive disorder
Kleptomania
Pyromania
Pathological gambling
Trichotillomania
Kleptomania is often comorbid with
Bulimia (1/4 of bulimics)
Pyromania is often present in
Mentally retarded individuals
Predisposing factors for pathologic gamgling often involve
Childhood/ family
Most effective therapy for pathologic gambling
Gamblers Anonymous
Rx for trichotillomania
SSRIs
Antipsychotics
Lithium
What is conversion disorder?
Neuro symptoms preceded by psychological stressor
Common symptoms of conversion disorder
Shifting paralysis, blindness, mutism, paresthesias, seizures, globus hystericus
Conversion syndrome in an older adult
Suspect neuro deficit
How do pts with a conversion disorder discuss their symptoms?
With calm indifference
Prognosis of conversion disorder?
Recover in 1mo
25% recur
How long must hypochondriasis persist for?
6mo
Difference between somatization and hypochondriasis
Somatization disorder pts are concerned about symptoms

Hypochondriacs are concerned about disease
5 stages of sexual response
Desire, excitement, plateau, orgasm, resolution
2 neurotransmitters that affect libido
Dopamine enhances libido
Serotonin inhibits libido
2 most common sexual disorders in women
Sexual diesire disorder
Orgasmic disorder
2 most common sexual disorders in men
Secondary erectile dysfunction
Premature ejaculation
What is second ED
Acquired after previous ability to maintain erections
Rx for female sexual arousal disorder
Release of clitoral adhesions
Rx for female orgasmic disorder
Masturbation
3 Rx methods for premature ejaculation
Squeeze technique
Stop-start technique
Use side effects of SSRIs/TCAs
3 most common paraphilias
Pedophilia, voyeurism, exhibitionism
3 paraphilias that can occur in women
Sadism, masochism, pedophilia
Sexual pleasure in men from rubbing their genitals against women in crowded areas
Frotteurism
Sexual excitement from calling unsuspecting women
Telephone scatologia
3 Rx options for paraphilias
Insight-oriented psychotherapy
Behavior therapy
Antiandrogens
Transsexuality is also known as
Gender identity disorder
Gender identity disorder is associated with an increased incidence of
MDD, anxiety, suicide
Gender identity is usually developed by age
3yo
4 exceptions to confidentiality
Subpoena
Child abuse
Tarasoff duty (harm to others)
Suicidal
How many physicians must determine need for involuntary admission?
2
Legal doctrine that allows forcible commitment
Parens patriae
Competence vs. capacity
Competence is a legal term
Capacity is a clinical term
Most important factor in predicting violence
History of violence
Criteria for not guilty by reason of insanity (3)
Mental illness, doesn't understand right from wrong, didn't understand consequences of actions at time act was committed
4 Ds fo malpractice
Dereliction (negliect) of a Duty that led Directly to Damages
2 types of damages awarded
Compensatory (for medical expenses, lost salary, physical suffering)

Punitive (to punish doctor for gross negligence)
MMSE dysfunction is below what score?
<25
Difference between impairment in dementia and delirium
Dementia: memory impairment
Delirium: sensorium impairment
Minimum workup to exclude reversible causes of dementia
CBC, Chem, TFTs, RPR, B12, folate, brain CT or MRI
Dementia w/ obesity, coarse hair, constipation
Hypothyroidism
2 types of delirium
Quiet and agitated
Rx for delirium symptoms
Quetiapine or haloperidol (avoid benzos --> confusion)
What can't you use haloperidol IV
Can cause torsades
Which has EEG changes, delirium or dementia, and what are they?
Delirium: fast waves or generalized slowing
Apraxia
Inability to perform purposeful movements
Agnosia
Inability to interpret sensations correctly (e.g. recognize things previously known)
Life expectancy of Alzheimer's
8 years after diagnosis
Neurotransmitter levels in Alzheimer's ()
Decreased acetylcholine and NE
2 classes or drugs for Alzheimer's and examples
NMDA antagonists: memantine

Cholinesterase inhibitors: donepezil (Aricept), rivastigmine (Exelon), tacrine (Cognex)
Rx for mania w/ kidney disease
Valproic acid or carbamazepine
First line for GAD
Buspirone
Rx for agitated mania
Haloperidol (acutely; lithium longterm)
Elevated cholesterol and carotene, prolonged QT, osteoporosis
Anorexia
Fever, rigidity, mental status changes, and autonomic instability
Neuroleptic malignant syndrome
Rx for neuroleptic malignant syndrome
D/c antipsychotics
ICU
Control hyperthermia
Maintain electrolyte balance
Dantrolene in severe cases
High fevers, rigidity, diarrhea, restlessness, autonomic instability
Serotonin syndrome
How long should a single MDE be treated for?
6mo following response
2 subtypes of anorexia
Restricting
Binge and purge
Pt who meets criteria for anorexia nervosa except has regular menses
Eating disorder NOS
Rx for Tourette syndrome
Typical antipsychotics (haloperidol or pimozide)
Rx for refractory enuresis
Desmopressin is first line (better safety profile)
Imipramine is second line
Two tests to get before starting lithium treatment
Creatinine
TFTs
Rx for social phobia (2)
Assertiveness training (part of CBT) and SSRI (e.g. paroxetine)
Management if only one parent consents for a treatment for a minor and the other refuses to agree?
Proceed! Only need consent from one parent or guardian
How to distinguish selective mutism and social phobia
Selective mutism: child refuses to talk
Social phobia: often 2/2 learning and communication disorders (e.g. stuttering)
When do kids usually grow out of stranger anxiety?
3yo (afterwards is generally attributable to another cause)
Who uses neurotic defense mechanisms?
Adults; usually provide short term relief
3 criteria for emancipated minor
Married
Military
Lives separately from parents and manages own finances
Abrupt cessation of what anti-anxiety med can caused generalized tonic-clonic seizures and confusion?
Alprazolam (short-acting benzo)
Methylphenidate should not be used in children younger than
6yo (safety/efficacy have not been evaluated)
Dilated pupils, HTN, tachy, psychosis
Amphetamine intoxication (similar to cocaine, but psychosis is more common with amphetamines)
Altered consciousness, respiratory depression, pinpoint pupils
Heroin intoxication
Rx for bereaved pts with continued extreme symptoms 2months after their loss
Antidepressant and psychotherapy
When might ECT be used as first line for MDD?
Severe suicidality and psychosis
Management of acutely suicidal pt whose parents want her to see her pediatrician instead of being hospitalized
Hospitalize anyway!
IVDU who contracts HCV and blames it on inadequate control of HCV within the community is an example of?
Distortion (altered perception of reality to make it more acceptable), an immature defense mechanism
Unfaithful husband who accuses his wife of infidelity
Projection (attributes unacceptable emotions to other individuals), an immature defense mechanism
Pt who was rescued from a burning building and now denies any memory of the event
Dissociation (blocking disturbing feelings form consciousness to avoid emotional upset), a neurotic defense mechanism
Magical thinking is associated with which PD?
Schizotypal
Birth defects associated w/ anticonvulsants (carbamazepine/ valproate)
Craniofacial defects
NTDs
Genital anomalies
Important diagnostic criteria for adjustment disorder (vs. normal human experience)
Functional impairment
Inheritability of bipolar disorder
High: 5-10% for first degree relatives (vs 1% for general population)
4 antipsychotics available in depot form
Haloperidol, fluphenazine (typical)
Risperidone, paliperidone (atypical)
Rx for psychosis if pt has severe EPS
Clozapine (or possibly typical antipsychotics)
Critical aspect of therapy for schizophrenics
Family therapy and keeping family conflict to a minimum
Pt w/ Hx of alcohol dependence presenting w/ auditory hallucinations and stable vitals
Alcoholic hallucinosis
Normal devt for at least 2yrs, then loss of previously acquired language, social, bowel/bladder, or play/motor skills followed by development of autistic symptoms
Childhood disintegrative disorder
How to distinguish autism from childhood disintegrative disorder
Autism symptom onset always begins before 3yo; rarely have a "regression" like in childhood disintegrative disorder, where children are normally before symptom onset
How to distinguish OCPD from OCD?
Pts with OCPD don't see it as a problem, and are more focused on perfectionism than particular obsessions/compulsions
3 subtypes of delusions
Grandiose, paranoid, somatic
4 first line and 2 second line maintenance meds for mania
Lithium, lamotrigine, olanzapine, quetiapine

Divalproex, aripiprazole
Most common side effect of ECT
Amnesia (anterograde resolves quickly, retrograde may persist)
Rare side effects of ECT (5)
Prolonged seizures, delirium, headache, nausea, skin burns
When can lithium be tapered?
For pts with one manic episode, after 1yr symptom free
When is lifelong lithium therapy recommended?
After 3 or more manic relapses
Woman who is angry with her husband and throws away his baseball card collection as retaliation is an example of
Displacement (neurotic defense mechanism): shifting of emotion associated w/ an upsetting person or object to a safer alternate object/person that represents the original
Battered woman who believes her husband is right when he says she is worthless
Introjection (immature defense mechanism): assimilating another person's attitude into one's own perspective
Person who needs to follow the rules of a game precisely may have which PD?
OCPD
Rx for adjustment disorder
Psychodynamic psychotherapy or CBT
Thing to be careful of with adjustment disorder
Timeline! If develops within 3mo of stressor and hasn't lasted >6mo, can be adjustment disorder and needs therapy, not SSRIs
Most common comorbid conditions in Tourette disorder (2)
ADHD (60%)
OCD (27%)
Rx for narcolepsy
Methylphenidate or modafinil (psychostimulants) for daytime somnolence +/- antidepressents for cataplexy
MAOI + tyramine containing food can cause
Hypertensive crisis
Stating that being fired is a "blessing in disguise" because pt can now spend more time with his family
Rationalization (neurotic defense mechanism)
Most likely atypical antipsychotic to cause EPS
Risperdal
Least likely atypical antipsychotic to cause EPS
Clozapine
Rx for fear of flying
Short acting benzo, e.g. alprazolam
Stepwise loss of function
Vascular dementia
DSM criteria for dementia
Memory impairment and at least one of: aphasia, apraxia, agnosia, diminished executive functioning
Dementia symptoms + focal neuro symptoms (hyperreflexia or paresthesias)
Vascular dementia
Diagnostic test for vascular dementia
MRI
Dementia w/ more personality/behavioral changes
Pick's disease/ frontotemporal dementia
What are Pick bodies?
Intraneuronal inclusion bodies
Prognosis of Huntington's
Death 15yrs after diagnosis
Psychotic depression, muscular hypertonicity, progressive dementia, choreiform movements
Huntington's
MRI in Huntington's shows
Caudate atrophy
2 classes of dementia w/ examples and symptoms
Cortical (Alzheimer's, Pick's, CJD): intellectual function declines

Subcortical (Huntington's, Parkinson's, NPH, multi-infarct): affective and movement symptoms
What % of Parkinson's pt develop dementia?
30%
5 causes of Parkinson's disease
Idiopathic (most common)
Traumatic
Drug-induced
Encephalitic
Familial
Pharma options for Parkinson's (5)
1) Levodopa + carbidopa (former crosses BBB, latter prevents conversion of levodopa to dopamine in periphery)

2) Amantadine (unknown)

3) Anticholinergics (for tremor)

4) Dopamine agonists (bromocriptine)

5) MAO-B inhibitors (selegiline): inhibit breakdown of dopamine
Surgical options for PD
Thalamotomy or pallidotomy if refractory
Iatrogenic cause of CJD
Corneal transplant
Dementia w/ myoclonus, EPS, LMN signs, ataxia
CJD
Prognosis/latency of CJD
Long latency btwn exposure and symptom onset, but then usually progresses to death w/in 1yr
4 other prion disease
Kuru
Gerstmann-Hraussler syndrome
Fatal familial insomnia
Bovine spongiform encephalopathy
What are prions?
Proteinaceous infectious particles, normally expressed by healthy nuerons but accumulations --> disease
EEG in CJD
Periodic sharp waves/spikes
Pathology of CJD
Spongiform changes of cerebral cortex, neuronal loss, hypertrophy of glial cells
Of triad of NPH, which is least likely to improve with shunt treatment
Dementia
Contusion w/ lucid intervals
Delirium
Best Rx for delirium after treating underlying cause
Low-dose antipsychotic
Amnestic disorders are always caused by an underlying ___ condition vs ____ condition
Medical, not psychiatric
Unusual antidepressant choice in pts who can't tolerate typicals meds, and risk of its use
Sympathomimetics (amphetamine-based): addiction potential
What must be assessed before prescribing TCAs?
Suicide risk (overdose can be lethal)
Hallmark of TCA toxicity
Widened QRS (>100 msec)
3 side effect categories of TCAs
Antihistaminic (sedation), antiadrenergic, antimuscarinic
7 examples of TCAs
Imipramine
Trimipramine
Desipramine
Clomipramine
Amitriptyline
Nortriptyline
Doxepin
Serotonin syndrome occurs from combining these two meds
SSRIs and MAOIs
Consideration when switching from SSRI to MAOI
Wait at least 2 wks to prevent serotonin syndrome
Which SSRI doesn't need a taper?
Fluoxetine/ Prozac
Which SSRI has the highest risk of GI disturbances?
Zoloft
Antidepressant also used for SAD and ADHD
Bupropion
Two low potency typical antipsychotics
Chlorpromazine and thioridazine
5 high potency typical antipsychotics
Haloperidol
Fluphenazine
Trifluoperazine
Perphenazine
Pimozide
High potency typicals have ___ EPS and ___ anticholinergic/antihistaminic side effects
More EPS

Less
Symptoms of NMS
FALTER

Fever
Autonomic instability
Leukocytosis
Tremor
Elevated CPK
Rigidity
What monitoring is required for quetiapine
Slit lamp exam q6mo to look for cataracts
Why do some atypicals have less weight gain?
Less anti-histamine action
Toxic and lethal doses of lithium
Toxic >1.5
Lethal >2
Carbamazepine is best for which two subtypes of bipolar
Rapid cycling
Mixed episodes
Carbamazepine is also used to treat which condition
Trigeminal neuralgia
3 long acting benzos (1-3 days)
Chlordiazepoxide (Librium)
Diazepam (Valium)
Flurazepam (Dalmane)
4 intermediate acting benzos (10-20hrs)
Alprazolam (Xanax)
Clonazepam (Klonopin)
Lorazepam (Ativan)
Temazepam (Restoril)
Common use for Librium
Alcohol detox
When can dystonia be life-threatening?
Dystonia of diaphragm --> asphyxiation