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15 Cards in this Set
- Front
- Back
Mania-Drugs to treat
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Lithium (ESkalith) gold standard, also Depakot and tegratol (Carbamazide) (neurontin, , lamictol-not on terms)
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Lithium toxicity
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Ed close to LD.Need blood monitoring. dose tapered off as Mania decraeses, because metabolism decreases
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LI+ Side effects
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1.Serious and dangerous- Thirst and polyurea-may indicate intoxication
2.Disturbing but not dangerous: Weight gain, fatigue, dry mouth, tremor (most disturbing) swoleen ankles, cog. effects |
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Tegratol and depakot were what before they were mood stabilizers?
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Anti SZ. meds, they also have a little antidepressant effect
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Zyprexa and ,mania
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works well according to Rickles, problem is a huge appetite and weight gain, normally a novel antipsychotic
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Antipsychotics, Traditional
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Thorazine, haldol, mellaril
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Antipsychotics, novel
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Clozapine, zyprexa, seroquel,Risperidone, gedeone belify
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Why are the novel antipsychotics better?
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Less TD and EPS. Less anticholinergic effects, Block DA and 5HT, more balanced
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Why TD and EPS
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Traditional antipsychotics block DA not only in the mesolimbic system (which decreases positive Schiz sxs, but also the mesocortical-making negative sxs worse and in the nigrostriatal-where they create a parkinson like syndrome called EPS or TD
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Novel antipsychotic down side
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Increase prolactin, can't use in women with history of hormone sensitive breast cancer, bring on type II diabetes.
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Antipsychotics also work for
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PSychotic, agitated depression, borderline, somatisizing
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If SSRI's and BZ's don't work for nervous nellies give what?
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Mood stabilizers-neurontin
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Meds and PD
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work 20 percent of the time, perhaps there is underlying deoression etc..or narcissist may be better
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When NOT to use psychotherapy without meds
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1. Schizophrenia
2. Manic Episode 3. MAjor depression |
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PSychotherapy treatment-Axis I vs. II
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We treat axis II disorders. clinical responsibility to think about the meds
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