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67 Cards in this Set
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- Back
- 3rd side (hint)
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What is the age of onset for ADHD?
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<7
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What is the age of onset for Tourette's
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<18
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How long do they have to have symptoms before diagnosing Tourette's?
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one year
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what are the low potency antipsychotics?
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thioridazine
chlorpromazine |
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What is the evolution of extra-pyramidal effects?
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4hrs: acute dystonia (muscle spasm, stiffness)
4days: akinesia (parkinsonian symptoms) 4wks: akathisia (restlessness) 4mos: tardive dyskinesia |
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What is neuroleptic malignant syndrome?
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rigidity
myoglobinuria autonomic instability hyperpyrexia |
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What are the specific eye toxcities from the low potency typical antipsychotics?
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chlorpromazine - corneal deposits
thioridazine - retinal deposits |
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What are the atypical antipsychotics?
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olanzapine
clozapine quetiapine risperidone aripiprazole ziprasidone |
"It's atypical for old closets to quietly whisper from A to Z"
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What is the MOA of atypical antipsychotics?
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block 5-HT2, dopamine, alpha and H1 receptors
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what is olanzapine used for?
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aka Zyprexa - atypical antipsychotic also used for OCD, anxiety disorder, depression, mania and Tourette's
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Clozapine toxicity
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agranulocytosis
requires weekly WBC monitoring weight gain |
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What is the MOA of typical antipsychotics?
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block D2 receptors (inc. intracellular concentration of cAMP)
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What is the difference between hypnagogic hallucination and hypnopompic hallucination?
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gogic - going to sleep
pompic - waking up |
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What are the 4 positive symptoms in schizophrenia diagnosis?
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hallucinations
delusions disorganized speech (loose association) disorganized behavior |
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how long is a brief psychotic disorder?
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<1 month
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how long is schizophreniform disorder?
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1-6 months
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How long before you can make the diagnosis of delusional disorder?
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>1 month
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How do you make the diagnosis of mania?
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>1 week of at least 3 of DIG FAST
Distractability Irresponsibility Grandiosity Flight of ideas inc. goal directed Activity/psychomotor Agitation dec. need for Sleep Talkativeness or pressured speech |
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How do you make the diagnosis cyclothymic disorder?
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> 2 years
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How do you make the diagnosis for Major Depressive Episode?
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At least 5 of SIG E CAPS for >2weeks (has to include depressed mood or anhedonia in the 5)
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How do you make the diagnosis of major depressive disorder
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>2 major depressive episodes with at least 2 months symptoms free in between
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How long to make the diagnosis of PTSD?
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>1 month
2days-1month = acute stress disorder |
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How long for adjustment disorder diagnosis?
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<6months (or >6months in if chronic stressor)
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How do you make the diagnosis of somatization disorder?
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variety of complaints in multiple organ systems (at least 4 pain, 2GI, 1 sexual, 1 pseudoneurologic) over a period of years
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What are the cluster A personality disorders?
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paranoid
schizoid schizotypal |
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What is the difference between schizoid and schizotypal personality disorders?
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schizoid is more aloof/withdrawn with social isolation and limited emotional expression (flat affect)
schizotypal is more eccentric appearance, odd beliefs, magical thinking, interpersonal awkwardness |
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What are the cluster B personality disorders?
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antisocial
borderline histrionic narcissistic |
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What are the cluster C personality disorders?
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avoidant
obsessive-compulsive dependent |
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What is the common metabolic disturbance in anorexia nervosa?
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hypokalemia
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How do you make the diagnosis of substance dependence?
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>1 year of 3 or more of the following:
tolerance withdrawl substance taken in larger amounts or over longer periods than desired persistent desire or unsuccessful attempts to cut back significant energy spent obtaining, using, or recovering from substance important social, occupation or recreational activities reduced because of substance use continued use in spite of knowing the problems that it causes |
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What is suboxone?
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naloxone (opioid antagonist) + buprenorphine (part agonist)
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What is methylphenidate?
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ritalin
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what is Dexedrine?
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amphetamine used in tx of ADHA
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How do you treat depression with insomnia?
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Mirtazapine
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How do you treat OCD?
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SSRIs
clomipramine |
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What are the "high potency" antipsychotics?
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haloperidol
trifluoperazine fluphenazine |
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What are the differences in side effects between high potency and low potency antipsychotics?
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high potency - extra-pyramidal
low potency - anticholinergic, antihistamin and alpha-blockade effects |
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How do you three Tourette's syndrome?
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Haloperidol
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Rett's disorder disorder presentation
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girls develop normally until ~age 4 and then regress - loss of development, mental retardation, loss of verbal abilities, ataxia, stereotyped hand-wringing
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What type of amnesia is Korsakoff's
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anterograde mainly but can have retrograde too
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Lithium toxicity
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tremor
sedation edema heart block hypothyroidism nephrogenic diabetes insipidus |
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What is the MOA of tricyclic antidepressants?
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block reuptake of NE and serotonin
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what are the tricyclic antidepressants?
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amitriptyline
nortriptyline imipramine clomipramine desipramine doxepin amoxapine |
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What are tricyclic antidepressent side effects?
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sedation
alpha-blocking effects anticholinergic effect (tachycardia, urinary retention) |
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What are tricyclic antidepressent toxicities?
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convulsions
coma cardiotoxicity (arrhythmias) respiratory depression hyperpyrexia confusion and hallucination in elderly due to anticholinergic effects |
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What is the tx for TCA overdose?
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Bicarb for CV symptoms
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Which TCA has the least sedative effects?
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desipramine
(also seizure threshold) |
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What are the symptoms of serotonin syndrome?
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hyperthermia
muscle rigidity cardiovascular collapse flushing diarrhea seizures |
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what is the tx for seratonin syndrome?
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cyproheptadine
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What are the SNRI's?
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venlafaxine
duloxetine |
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What is venlafaxine also used for?
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GAD
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what is duloxetine also used for?
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peripheral neuropathy
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Which SNRI has more affect on NE?
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duloxetine
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What are the SNRI toxicities?
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inc. BP
stimulant effects sedation nausea |
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What are the MAOi's?
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Phenelzine
tranylcypromine isocarboxazid selegiline |
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What is the MOA of MAOi's?
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inc. levels of amine neurotransmitters (NE, serotonin, dopamine)
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What is the clinical use of MAOi's?
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atypical depression
anxiety hypochondriasis |
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What is MAOi toxicity?
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hypertensive crisis with tyramine ingestion and beta-agonists
CNS stimulation contraindicated with SSRIs and meperidine (to prevent serotonin syndrome) |
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Mirtazapine MOA
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alpha-2 antagonist (inc. release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist
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Mirtazapine clinical use
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atypical antidepressant
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Mirtazapine toxicity
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sedation
inc. appetite weight gain dry mouth |
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Maprotiline MOA
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blocks NE reuptake
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Maprotiline clinical use
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atypical antidepressant
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Maprotiline toxicity
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sedation
orthostatic hypotension |
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Trazodone MOA
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inhibits serotonin reuptake
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Trazodone clinical use
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insomnia
at high doses, antidepressant effects |
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Trazodone toxicity
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sedation
nausea priapism postural hypotension |
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