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244 Cards in this Set
- Front
- Back
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this type of study compares a group of people with a disease to a group of people who dont have the disease
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case control
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this type of study compares a group of people with a given risk factor to a group of people without the risk factor
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cohort study
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this type of study collects data from a group of people to assess the frequency of a disease at a particular point in time
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cross sectional
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proportion of all people WITH a disease who test positive
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sensitivity
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proportion of all people WITHOUT a disease who test negative
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specificity
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does specificity rule in or rule out a disease
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sensitivity rules out a disease
specificity rules in a disease |
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Does increasing the threshold increase or decrease sensitivity? what about specificity?
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increasing threshold decreases sensitivity
increasing threshold increases specificity |
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equation for sensitivity
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TP/ (TP + FN)
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equation for specificity
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TN / (TN + FP)
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equation for positive predictive value
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TP / (TP + FP)
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equation for negative predictive value
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TN / (TN + FN)
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difference between incidence vs. prevalence
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incidence is the rate of a new disease
prevalence is the total number of people with the disease |
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difference between precision vs. accuracy
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precision is the reliability of a test
accuracy is the validity of a test |
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this type of bias occurs when a researcher's belief in the efficacy of a treatment changes the outcome
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pygmalion effect
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this type of bias occurs when the group being studied changes its behavior owing to the knowledge that they are being studied
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hawthorne effect
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this type of bias occurs when information is gathered at inappropiate times such as using surveys to study fatal diseases (only those still alive are able to answer)
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late-look bias
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in this type of bias, early detection is confused with increased chance of survival
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lead-time bias
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this type of bias occurs when there are 2 closely related factors, and the effect that one factor has distorts/confuses the effect of the other factor
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confounding bias
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how do the mean, median, and mode relate to one another in positively and negatively skewed distributions
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positive skew: mean > median > mode
negative skew: mean < median < mode |
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what is a t-test
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checks the difference between the means of 2 groups
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what is an ANOVA test
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checks the difference between the means of 3 or more groups
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what is a chi-square test
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checks the difference between 2 or more percentages of outcomes (NOT means)
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leading cause of death in the US in infants
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congenital anomalies
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leading cause of death in the US in children and teenagers
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random injury
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leading causing of death in the US in adults
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cancer
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leading cause of death in the US in the elderly
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heart disease
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which diseases are reportable
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HAV
HBV HCV HIV AIDS Salmonella Shigella Syphilis Measles Mumps Rubella TB Chickenpox Gonorrhea |
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difference between Medicare and Medicaid
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Medicare is for the elderly
Medicaid is for the poor |
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what are the 4 parts of Medicare
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Part A: inpatient care, hospice, hospital care
Part B: outpatient care, PT, OMM Part C: combined A/B Part D: prescription drugs |
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4 exceptions to informed consent
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1. patient is legally incompetent
2. emergency situitations 3. therapeutic privilege (withholding info because full disclosure would harm or undermine the patient) 4. patient has waived their rights |
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when is parental consent NOT required for a minor
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if the minor is emancipated
if its an emergency when prescribing contraceptives treatment of STDs medical care during pregnancy management of drug addictions |
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at what times are Apgar scores taken
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1 and 5 minutes
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what 5 things are assessed in an Apgar score
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appearance (blue; pink trunk; pink)
pulse (no pulse; <100; >100) grimace (no grimace; grimace; grimace+cough) activity (limp, some flexion, active flexion) respiration (none, irregular, regular) |
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what a normal Apgar score
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greater than or equal to 8
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what are the normal motor and cognitive milestones of a 3 year old
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stacks 8/9 blocks, rides a tricycle, copies lines/circles drawings, toilet training, speaks in complete sentences, and has a 900 word vocabulary
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what are the normal motor and cognitive milestones of a 3 month old
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holds head up, Moro reflex disappears, social smile
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when does a baby develop stranger anxiety
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8 months
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at what Tanner Stage do the breasts start enlarging
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stage 2
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at what Tanner Stage do the glans develop and scrotal skin darken
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stage 4
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at what Tanner Stage do the areolae become raised
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stage 4
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at what Tanner Stage does the pubic hair darken
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stage 3
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what EEG waves are present when someone is awake, alert, and active
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beta waves
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what EEG waves are present when someone is awake but resting with their eyes closed
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alpha waves
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what EEG waves are present when someone is in stage 1 sleep
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theta waves
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what EEG waves are present when someone is in stage 2
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sleep spindles and K complexes
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what EEG waves are present when someone is in deep sleep
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delta waves
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what EEG waves are present when someone is in REM sleep
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beta waves (some as when awake)
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which EEG waves are the highest frequency and lowest amplitude
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beta waves
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which EEG waves are the lowest frequency and highest amplitude
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delta waves
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sleepwalking, night terrors, and bedwetting are all seen in what sleep stage
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deep sleep (stages 3,4)
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dreaming, erections, and memory formation occur during which sleep stage
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REM sleep
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bruxism occurs during which sleep stage
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stage 2
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physiologic responses by the body during REM sleep
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loss of muscle tone, increased oxygen use, increased metabolism
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during which sleep stage is GH secreted in large quantities in childhood
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deep sleep (stages 3,4)
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strenuous exercise during the day has largest effect on which sleep stage
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deep sleep (stages 3,4)
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neurotransmitter that mediates REM sleep
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ACh
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MOST important neurotransmitter initiating sleep
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serotonin
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which brain stem controls eye movements during REM sleep
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PPRF
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DOC for bedwetting (enuresis)
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imipramine
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treatment for night terrors and sleep walking
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benzodiazepines
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substances that decrease REM
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alcohol, benzodiazepine, barbiturates
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which stage of sleep represents the largest proportion of total sleep time
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stage 2
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effects of depression on sleep
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decreases deep sleep
decreases REM latency increases total REM sleep repeated nighttime awakenings early morning awakening |
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treatment of narcolepsy
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amphetamines, modafinil, sodium oxybate
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symptoms of narcolepsy
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excessive daytime sleepiness, hypnagogic/hypnopompic hallucinations, cataplexy, and disordered regulation of the sleep-wake cycle
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nucleus that regulates circadian rhythms
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suprachiasmatic nucleus
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what secretes melatonin
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pineal gland
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difference between classical and operant conditioning
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classical conditioning: a natural response is elicited by a learned stimulus
operant conditioning: specific action is elicited because it produces a reward |
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difference between positive and negative reinforcement and what type of conditioning is it seen in
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positive reinforcement: desired reward produces action
negative reinforcement: behavior is elicited to avoid or by removal of an adverse stimulus *these methods of reinforcements are seen in operant conditioning |
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According to Freud, which portion of the mind is absent in criminals
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they lack the superego
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according to Freud, which portion of the mind utilizes defense mechanisms
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the ego
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according to Freud, which portion of the mind is entirely subconscious and is responsible for primal urges such as sex and aggression
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the Id
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what are the 4 "mature" defense mechanisms
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altruism, humor, sublimation, suppression
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defense mechanism characterized by temporary, drastic changes in personality, memory, consciousness, or behavior to avoid emotional stress
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dissociation
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someone with severe dissociation can result in what disorder
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multiple personality disorder
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defense mechanism characterized by avoided ideas and feelings are transferred to some neutral person or object
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displacement
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defense mechanism characterized by an unacceptable internal impulse attributed to an external source
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projection
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defense mechanism characterized by unacceptable feelings/ideas are unconsciously replaced by an emphasis on the exact opposite
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reaction formation
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defense mechanism characterized by emotionally reverting back to childhood
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regression
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difference between repression and suppression
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repression is involuntary and suppression is voluntary
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defense mechanism characterized by the belief that all people are either good or bad at different times
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splitting
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splitting is associated with what personality disorder
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borderline personality disorder
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defense mechanism characterized by replacing an unacceptable wish or action with one that is similar but doesn't conflict with one's values or morals
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sublimation
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sex addict gives up sex and instead writes couples self-help books about sex is an example of what type of defense mechanism
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sublimation
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choosing not to think about an exam until the night before is what defense mechanism
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suppression
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a mafia boss makes a large donation to a funeral home is an example of what type of defense mechanism
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altruism
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patient says all doctors and nice and all nurses are mean
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splitting
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teenager can't remember being raped is what defense mechanism
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repression
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child starts bedwetting again when his little brother is born is an example of what type of defense mechanism
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regression
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a pervert becomes a monk is an example of what type of defense mechanism
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reaction formation
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childhood disorder characterized by limited attention span, poor impulse control, hyperactivity, motor impairment, and emotional lability; commonly has difficulty in school despite normal intelligence
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ADHD
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DOC for ADHD
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methylphenidate
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MOA of methylphenidate
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increase dopamine
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childhood disorder characterized by repititive pervasive behaviors including physical aggression, destruction of property, and theft
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conduct disorder
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conduct disorder that does NOT spontaneously remit after childhood can become what personality disorder
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antisocial personality disorder
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childhood disorder characterized by patterns of hostile and defiant behavior towards authority figures
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oppositional defiant disorder
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patient presents with random, brief jerky movements in his extremities and head; these symptoms have been ongoing randomly for the past year; coprolalia is noted during the PE
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Tourettes
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Tourettes commonly occurs along with what personality disorder
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OCD
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treatment for Tourettes
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haloperidol (DOC), pimozide, clonidine
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characterized by severe language impairment and poor social interactions; tendency to focus on innanimate objects rather than people; behaviors are reptitive; patient has trouble making eye contact
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autism
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mild developmental disorder characterized by reptitive behaviors and problems socializing; intelligence is normal; there is no language impairment
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Asperger's
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special type of autism characterized by having a unique/unusual ability often confused with genius intelligence
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savant
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X-linked disorder seen only in girls characterized by loss of development, mental retardation, loss of verbal abilities, ataxia, and stereotyped handwriting
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Rett's disorder
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neurotransmitter imbalance seen in anxiety
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increased NE
decreased GABA decreased serotonin |
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neurotransmitter imbalance seen in depression
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decreased NE
decreased serotonin decreased dopamine |
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neurotransmitter imbalance seen in Alzheimers
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decreased ACh
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neurotransmitter imbalance seen in Huntingtons
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decreased GABA
decreased ACh |
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neurotransmitter imbalance seen in Schizophrenia
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increased dopamine
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neurotransmitter imbalance seen in Parkinsons
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decreased dopamine
increased serotonin increased ACh |
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DOC for the tremors in Tourettes and other movement disorders
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propanolol
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does delirium have a normal EEG? what about dementia?
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delirium has an abnormal EEG
dementia has a normal EEG |
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perceptions in the absence of external stimuli
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hallucination
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a dehydrated person stranded in the desert sees a lake when its not really there is an example of what
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hallucination
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misinterpretations of actual present external stimuli
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illusion
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When a doctor enters the room, the patient looks at the doctor and screems saying she sees an evil clown-- this is an example of what
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illusion
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false beliefs that are not shared by members of a culture that a person maintains despite obvious proof disproving it
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delusion
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a patient cowers in fear seeing nurses walking through the halls and thinks they are all aliens planning her abduction-- this is an example of what
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delusion
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visual hallucinations are associated with what condition
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delirium and drug toxicity
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auditory hallucinations are associated with what condition
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schizophrenia
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olfactory hallucinations are associated with what 2 conditions
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epilepsy and brain tumors
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tactile hallucinations are MOST commonly seen in what 2 conditions
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alcohol withdrawal and cocaine addicts (they often feel bugs crawling on their limbs)
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difference between a hypnagogic and hypnopompic hallucination
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hypnagogic: occurs prior to falling asleep
hypnapompic: occurs after waking from sleep |
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schizophrenia lasting <1 month and linked to stress
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brief psychotic disorder
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schizophrenia lasting 1-6 months
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schizophreniform disorder
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characterized by a 2 week period of psychotic, schizophrenia-like symptoms combined with either major depression, a manic episode, or combination of the 2
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schizoaffective disorder
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time frame needed to diagnose schizophrenia
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symptoms MUST last >6 months
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illicit drug linked to schizophrenia in teens
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marijuana
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this type of schizophrenia is often confused by the religious community for demonic possession
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catatonic schizophrenia
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what are the positive symptoms of schizophrenia
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delusions
hallucinations (auditory) disorganized speech catatonic behavior |
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what are the negative symptoms of schizophrenia
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flatt affect
social withdrawal lack of motivation lack of speech or thought |
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type of schizophrenia characterized by poor grooming habits, disheveled appearance, silliness, facial grimacing, mirror gazing, and an early age of onset
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disorganized schizophrenia
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type of schizophrenia characterized by stupor, agitation, lack of coherent speech, bizarre postures, abnormal flexibility/contorsions, and lack movement or emotional repsonses for hours at a time
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catatonic schizophrenia
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type of schizophrenia characterized by grandiose delusions of persecution; age of onset is older than other types
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paranoid schizophrenia
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subtype of schizophrenia that is a combination of at least 2 different types of schizophrenia
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undifferentiated schizophrenia
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type of schizophrenia characterized by previous episodes of psychosis causing residual symptoms-- but no current symptoms of psychosis
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residual schizophrenia
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patient presents with psychotic symptoms and is noted for the recent development of delusions; he had no past history of any psychological disorders nor does he have any family history of them; social history revealed that he started dating a new woman 6 months ago who suffers from delusional disorder; what is the man diagnosed with
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shared psychotic disorder (folie a deux)
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characterized by a single persistent, nonbizarre belief lasting more than 1 month
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delusional disorder
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MOST common group of people to suffer from dissociative identity disorder (aka multiple personality disorder)
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women with a history of sexual abuse
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abrupt change in geographic location leading to dissociation of one's identity; usually linked to traumatic circumstances
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dissociative fugue
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characterized by a 1 week period of easy distractibility, irresponsibility, grandiosity, flight of ideas, agitation, decreased need for sleep, and talkativeness
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manic episode
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difference between manic and hypomanic episode
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hypomanic episodes are like manic episodes but not severe enough to cause marked impairment in social and occupational functioning; there is no need to hospitalize and no psychotic features
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difference between bipolar I and bipolar II disorder
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bipolar I has manic episodes
bipolar II has hypomanic episodes |
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DOC for bipolar disorder
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lithium
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what is cyclothymic disorder
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combination of dysthymia (mild depression lasting >2 years) and hypomanic episodes
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mild depression lasting >2 years
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dysthymia
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differences between normal grief and depression
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normal grief:
-minor weight loss (<5 lbs) -minor sleep disturbance -mild guilt -illusions -attempts to return to work and socializing -cries and expresses their sadness -severity decreases after 2 months -all symptoms resolve within 1 year -treatment is supportive with sleep agents Depression: -significant weight loss (>5% of body) -significant sleep disturbance -intense guilt -hallucinations and delusions -doesnt resume work or socializing -suicidal -severe symptoms last >2 months -symptoms progress >1 year -treatment is benzodiazepines, antidepressants, antipsychotics, ECT |
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time difference between grief and depression
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grief resolves within 1 year
depression lasts >1 year |
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symptoms of atypical depression that differ from regular depression
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atypical depression has hypersomnia, overeating, and mood reactivity
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treatment of atypical depression
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MAOIs
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difference in the time periods between postpartum blues, postpartum depression, and postpatum psychosis
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postpartum blues (50-85% of women): resolves within 10 days
postpartum depression (10-15% of women): lasts 2 weeks - 2 months postpartum psychosis: (0.1% of women): lasts 4-6 weeks |
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a patient is in risky surgery for a hemorrhage in his femoral artery after a work-related incident; the patient dies and the doctor tells the spouse the bad news; upon hearing of her husband's death, she experiences heart palpitations, nausea, light-headedness, chest pains, chills, sweating, shaking, and shortness of breath; what is happening
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panic attack
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2 MOST common examples of social phobias
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public speaking and using public restrooms
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condition characterized by having panic-like symptoms in wide open spaces, crowds, or uncontrollable public situations
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agoraphobia
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DOC for OCD
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clomipramine
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patient presents for a routine annual physical; when you walk in she is on the phone, but then quickly ends the call-- after hanging up, you notice she opens and closes her phone 3 times before putting in away in her purse; during the history you note that she is very persistent on needing to be in a clean environment--she admits to using hand sanitizier dozens of times per day and vacuums in the morning and night; after the PE, when she is putting her shoes back on you also notice she unties and ties her shoes 3 times before standing up; what underlying condition does she likely have
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OCD
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time difference between acute stress disorder and PTSD
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<1 month is acute stress disorder
>1 month is PTSD |
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a veteran presents for a complete history/physical after returning from war several months ago; his history is remarkable for recurrent nightmares of his killings during the war--some nights he says he can only manage 2 hours of sleep because of it
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PTSD
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time frame required to diagnose general anxiety disorder
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>6 months
(<6 months is considered adjustment disorder) |
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patient presents to his psychiatrist with complaints of ongoing anxiety for the past year; the anxiety does not appear to be related to a specific person, event, or situation; as a result, the patient has had trouble sleeping and has had frequent heartburn
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general anxiety disorder
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patient presents complaining of severe back pain; all tests are negative; PMH is remarkable for oxycodon abuse
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malingering
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difference between malingering and factitious disorder
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malingering ceases after secondary gain (i.e. drugs, work compensation)
facititious disorder does NOT cease after primary gains (i.e. receiving medical care is their sole motive) |
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patient presents complaining of lower back pain; PMH is remarkable for several outpatient visits in the last year; after the PE findings come back negative, the patient is not satisfied and asks for blood work, and MRI, and colonoscopy
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Munchausen's syndrome (aka chronic factitious disorder)
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condition characterized by a caregiver knowingly and willingly causing illness to a child to assume the sick role
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Munchausens by proxy
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which complaints are alway present in somatization disorder
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patient has at least 4 complaints with at least 2 GI, 1 sexual, and 1 neuro complaint
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characterized by sudden loss of both sensory and motor function (eg. limb paralysis and blindness) following an acute stressor
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conversion disorder
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anxiety over having a serious medical condition despite medical evaluation and reassurance
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hypocondriasis
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DOC for hypocondriasis
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MAOI
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characterized by preoccupation with imagined and usual false defects in appearance; PMH will be remarkable for several cosmetic surgeries or intent for them
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body dysmorphic disorder
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personality disorders appear under what axis of the DSM assessment
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DSM-II
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clinical disorder, mental disorders, and learning disorders appear under what axis of the DSM assessment
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DSM-I
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acute medical conditions and physical disorders appear under what axis in the DSM assessment
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DSM-III
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psychosocial and environmental factors affecting one's condition appear under what axis of the DSM assessment
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DSM-IV
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what are the cluster A personality disorders
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paranoid, schizoid, schizotypal
(the "weird" ones) |
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what are the cluster B personality disorders
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antisocial, borderline, histrionic, narcissistic
(the "wild" ones) |
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what are the cluster C personality disorders
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avoidant, obsessive-compulsive, depedent
(the "worried" ones) |
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during a routine H/P, the patient appears to acting very suspiciously and doesn't seem to trust you; he admits to having an affair, yet he is also worried that his wife is cheating on him; what personality disorder does he MOST likely have?
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paranoid
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which defense mechanism is linked to a paranoid personality disorder
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projection
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a patient returns to his oncologist for reading of his lab results; upon telling the patient he doesn't have cancer, he has no emotional response--the doctor questions him to see if he understands the good news, to which the patient replies "that's good" but still showing no emotion; his PMH is remarkable for social withdrawal, yet he appears content with his life the way it is; what personality disorder does he MOST likely have
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schizoid
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MAJOR difference between schizoid and avoidant personality disorders
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schizoid patients are content with their social and emotional withdrawal
avoidant patients desire relationships and emotional bonds but are too fearful to pursue them |
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During rotations, you come across a patient who is very well groomed and sharply dressed, yet he is stammering on and on about his theory that he and his friends can fly; toxicology screens are negative; what personality disorder does he MOST likely have
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schizotypal
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personality disorder characterized by a disregard for an violation of the rights of others; prone to criminal acts; more common in males
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antisocial
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after breaking up with her boyfriend of 2 years, she reports that he is now stalking her and threatening suicide if she doesnt get back together with him; she states that during their relationship, his mood was often unstable in social situations, he had very few friends, he was promiscuous at times and occassionally would cut himself; what personality disorder does he MOST likely have
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borderline
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upon entering the room for a routine H/P with a female patient, you note that she is dressed in very revealing clothing and flirts with you; after speaking with one of your colleagues, he mentions that the same thing happened to him, when he saw her several weeks ago for a physical; what personality disorder does the woman MOST likely have
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histrionic
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during a routine H/P with a patient, he notes that he recently got promoted in his job and expresses his idea that he is more qualified than the CEO of the company; he also made a crude joke about his coworker and friend of whom he won the promotion over; upon questioning him aboout his job, he reacts with sudden rage and becomes defensive; what personality disorder does he MOST likely have
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narcissistic
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25 y/o male patient has a history of poor socialization and has had few friends in his life; he has never had a girlfriend for fear of rejection though he does want a relationship; what personality disorder does he MOST likely have
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avoidant
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you are seeing an 18 y/o female patient for the first time; upon questioning her about her school (she is about to graduate a senior in high school), she goes on and on about wanting to have the highest GPA in her school; she tells you that she will be graduating 3rd in her class of 400, yet is very disappointed she is not number 1; further questioning reveals she is a very organized and clean person, and makes it a priority to help maintain the house with her parents; what personality disorder does he MOST likely have
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obsessive-compulsive
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a teenage girl meets with a psychiatrist for the first time; she explains difficulty she has had maintaining relationships; she has had 9 boyfriends in the past year, all of whom broke up with her saying she was extremely clingy and wanted to be taken care of; during the H/P, you suspect she has a low self-confidence; what personality disorder does he MOST likely have
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dependent
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female patient presents complaining of amenorrhea; her PMH is remarkable for multiple fracutres; labs reveal anemia and electrolyte imbalances; her BMI is 15.8; whats the MOST likely diagnosis
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anorexia nervosa
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female patient presents for an annual H/P; PE is remarkable for enamel erosion and calluses on the dorsal side of her hands; labs reveal electrolyte disturbances and alkalosis; PMH is remarkable for parotitis; it's noted that she became very tense when questioned about her diet; what's the MOST likely diagnosis
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bulimia
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what is Russell's sign
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calluses on the dorsal side of the hand seen in bulimia (formed from inducing vomiting)
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during a smoking cessation counselling, the patients admits she would like to quit smoking, but doesnt intend to in the near future; what stage is she in
|
contemplation
|
|
|
during a smoking cessation counselling, the patient denies that her smoking is a problem to her health; what stage is she in
|
precontemplation
|
|
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during a smoking cessation counselling, the patient admits she is ready to quit smoking and discusses all possible treatment with you; what stage is she in
|
preparation/determination
|
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lab test specific for alcohol intoxication
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GGT
|
|
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how will AST compare to ALT in alcohol toxicity
|
AST will be twice ALT
|
|
|
DOC for alcohol toxicity
|
naltrexone
|
|
|
treatment for alcohol withdrawal (delirium tremens)
|
benzodiazepines
|
|
|
patient presents in ED with vomiting and seizures; PE is remarkable for pinpoint pupils and CNS depression; what overdose is MOST likely
|
opioids
|
|
|
DOC for opioid overdose
|
naloxone, naltrexone
|
|
|
DOC for benzodiazepine overdose
|
flumazenil
|
|
|
patient presents to the ED with severe chest pain; cardiac enzymes are within range; PE reveals pupillary dilation, tactile hallucinations, paranoid ideations; what overdose is MOST likely
|
cocaine
|
|
|
treatment of cocaine overdose
|
benzodiazepines
|
|
|
patient presents to ED with delirium and psychosis; PE is remarkable for fever, vertical/horizontal nystagmus, tachycardia, and excessive salivation; what overdose is MOST likely
|
PCP
|
|
|
patient presents to the ED with marked anxiety and delusions; PE reveals visual hallucinations and pupillary dilations; the patient also appears to having a flashback from a random event in his past; what overdose is MOST likely
|
LSD
|
|
|
patient presents to the ED with paranoid delusions and anxiety; PE reveals impaired judgement, dry mouth, hallucinations, and increased hunger; the patient appears to be in a euphoric state; what overdose is MOST likely
|
marijuana
|
|
|
long-term treatment for heroin addicts
|
methadone or suboxone
|
|
|
DOC for chronic alcoholism
|
disulfiram
|
|
|
DOC for depression with insomnia
|
Mirtazapine
|
|
|
MOA of antipsychotics
|
blocks D2 receptors
|
|
|
neuroleptic malignant syndrome is a SE with what class of drugs
|
antipsychotics
|
|
|
serious, irreversible SE of antipsychotics
|
tardive dyskinesia
|
|
|
SE of chlorpromazine
|
corneal deposits
|
|
|
SE of thioridazine
|
retinal deposits
|
|
|
DOC for neuroleptic malignant syndrome
|
dantrolene
|
|
|
patient presents to the ED with rapid onset high fever and rigidity of the muscles; his vitals are unstable; his PMH is remarkable for Schizophrenia diagnosed more than 20 years ago; he has been on the same medications for the whole duration; what is he diagnosed with?
|
neuroleptic malignant syndrome (secondary to his anti-psychotic meds)
|
|
|
MOA of the newer atypical antipsychotics
|
blocks 5-HT2, dopamine, alpha, and H1 receptors
|
|
|
SE of clozapine
|
agranulocytosis
|
|
|
major benefit of using the newer atypical antipsychotics
|
less side effects and does NOT cause tardive dyskinesia
|
|
|
MOA of lithium
|
inhibits phosphoinositol cascade
|
|
|
cardiac defect linked to lithium
|
Ebstein's anomaly
|
|
|
SE of lithium
|
tremor, edema, heart blocks, hypothyroidism, nephrogenic diabetes insipidus, teratogen
|
|
|
DOC for general anxiety disorder
|
buspirone
(because its not affected by alcohol and doesnt have sexual SE associated with SSRIs) |
|
|
MOA of TCAs
|
blocks reuptake of NE and serotonin
|
|
|
major toxicities linked to TCAs
|
convulsions, coma, cardiotoxicity ("The 3 C's")
|
|
|
DOC for TCA overdose
|
sodium bicarbonate
|
|
|
TCA recommended for use in elderly
|
nortriptyline
|
|
|
why are most TCAs contraindicated in the elderly
|
causes severe confusion and hallucinations
|
|
|
TCA that can be used in Parkinsons
|
amitriptyline
(due to anticholinergic effects) |
|
|
normal time period for antidepressants to show effects in the patient
|
2-4 weeks
|
|
|
generally the safest class of anti-depressants due to its limited and mild SE
|
SSRIs
|
|
|
major SE of SSRI that most people complain about
|
sexual dysfunction
|
|
|
DOC for serotonin syndrome
|
cyproheptadine
|
|
|
never combine an SSRI with what drugs?
|
MAOIs or meperidine
(causes serotonin syndrome) |
|
|
SNRI that can be used to treat diabetic neuropathies
|
duloxetine
|
|
|
SNRI that can be used to treat general anxiety disorder
|
venlafaxine
|
|
|
major SE of MAOI (when used alone)
|
hypertensive crisis secondary to tyramine ingestion
|
|
|
foods that contain tyramine and thus should be avoided in people taking MAOIs
|
red wine and aged cheese
|
|
|
antidepressant used in smoking cessation
|
Bupropion
|
|
|
MOA of mitrazapine
|
alpha-2 antagonist
|
|
|
SE of mitrazapine
|
sedation, weight gain
|
|
|
antidepressant used for insomnia
|
Trazodone
|
|
|
major SE of trazodone
|
priapism and postural hypotension
|
|
|
DOC for insomnia
|
zolpidem (ambian)
|
|
|
MOA of ramelteon
|
increases melatonin secretion
|
