mental health tx

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alyspins
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309663
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mental health tx
Updated:
2015-10-15 15:12:01
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mental health
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pharm mental health
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  1. Panic disorder tx
    • avoid precipitating factors;
    • antidepressants & benzos
    • ALPRAZOLAM; PAROXETINE
    • cbt
  2. agoraphobia tx
    • pharm like panic;
    • therpay: supportive; insight; behavior; cognitive; virtural
  3. SSRIs
    • Prozac (fluoxetine)
    • Paxil (paroxetine)
    • Zoloft (sertraline)
    • Celexa (citalopram)
    • Lexapro (escitalopram)
    • Luvox(fluxamine)
  4. TCAs
    • Tofranil (imipramine)
    • Elvavil (amitriptyline)
    • Sineuan (doxepin)
    • Desipramine(norpramin)
    • Nortiptyline (Pamelor)
  5. SNRIs
    • Effexor (venlafaxine)
    • Cymbalta (duloxetine)
    • Pristiq (desvenlafacine)
  6. NDRIs
    • Bupropion(Wellbutrin)
    • Desyrel (Trazodone)
  7. Mirtazapine (Remeron)
    • TeCa
    • Higher dose= less sedation
    • Appetite stimulation
  8. Mood stabilizers
    • Carbamazepine
    • Depakote
    • Lamictal
    • Topamax
    • Lithium
  9. Antipsychotics
    • Risperal
    • Zyprexa
    • Seroquel
    • Geodone
    • Abilify
    • Clozaril
    • Fanapt
    • Saphris
    • Latude
    • Haldol-first gen
  10. Benzo od antidote
    Romazicon
  11. Benzos
    • Xanax
    • Ativan
    • Valium
    • Restril
  12. Serotonin syndrome sx
    • Agitation; restless
    • Confusion, tachycardia
    • Sweating; shivering
    • Myoclonus; fever
    • Abd cramp
  13. Drugs that may-> serotonin syndrome
    • Linezolid
    • Tedizolid
    • Meperidine
    • Tramadol
  14. Serotonin syndrome tx
    • Antivan(benzo)
    • cyproheptidine
  15. MAOI side effect
    • Hypertensive crisis
    • Serotonin syndrome
    • Drowsiness/fatigue
    • Low bp
    • Dec sexual fx
    • Wt gain
  16. Hypertensive crisis
    • Tyramine foods
    • Antidote: phentolamine
  17. MAOI drugs
    • Nardil
    • Parnate
    • Marplan
    • Emsam (selective)
  18. TCA uses
    • Tofranil-bed wetting
    • Amitriptyline-neuropathic pain, insomnia
    • Doxepin-itching
    • Desipramine-insomnia
    • Nortriptyline-neuropathic pain
  19. Ssri long half life
    Prozac
  20. Ssri discontinuation syndrome drug
    Paxil
  21. Paxil
    • Shortest half life
    • Preg type D
    • Strong 2d6 inhibitor
  22. Prozac
    • Most activating CNS ssri
    • Titrate up
    • Longest half life
  23. NO tamoxifen/tramadol
    • b.c strong 2D6 inhbitor
    • paxil and prozax
  24. qt prolongation
    • celexa
    • lexapro
    • Geodon (antipsych)
  25. luvox/fluvoxamine
    • OCD
    • Titrate slowly
  26. Ssri side effects
    • Bruxism
    • Weird dreams
    • Anhedonia
    • Wt change
    • Dec libido
  27. SSRI discontinuation syndrome
    • Flu-like rxn: HA, N, gi distress;
    • Strange sensations of vision or touch
  28. Effexor ctn
    • CV: doses >225=HTN
    • HA, wt loss nausea
  29. Buproprion
    • Lowers seizure threshold
    • Doesn't cause wt gain or sexual dysfx
    • Inhibits dopamine
    • Ndris tx sex dys fx & wt gain
  30. Trazadone
    • PRIAPISM
    • NOT MONOTHERAPY
    • Sedation se
  31. Serzone
    Hepatic vailure
  32. Carbamazepine
    • Induces own metabolism
    • HLAb*1502 INC RISK OF SJS
    • Blurred vision; diplopia
    • Leukopenia and hyponatremia
  33. Depakote
    • Migraines; anti epicleptic; bipolar
    • +cabapenems=> SEIZURE
    • SE: hyperinsulinemia; PANCREATITIS; pcos
    • LIVER TOXICITY/FAILURE
  34. LAMICTAL
    • MOST SERIOUS ADR=RASH
    • SE like carbamaine
    • Cant take w/ Depakote
  35. Topamax
    • WEIGHT LOSS
    • Kidney stones
    • Adr: ataxia; add
  36. REGULAR BLOOD WORK
    • Carbamazepine: dec blood cells
    • Depakote: LIVER
    • Lithium-toxicity
  37. Lithium DI
    • Anthing w/ NA
    • NSAID, dehydration; ACEI
    • ARBs; diuretics;
  38. Lithium
    • Narrow therapeutic
    • Avoid Na drugs
    • Can be removed w/ hemodialysis
    • Lithium tox
  39. Lithium toxicity
    • Repeated V/Dl tremors
    • Difficulty walking
    • Sleepiness
    • Slurred speech
    • Blurred vision
    • Muscle twitches and seizures
  40. SE atypical antipsych
    • Dystonia
    • Akathisisia
    • Akinesia
    • Nes
    • TARDIVE DYSKINESIA
  41. Neuroleptic malignant syncrome
    • MEDICAL EMERGENCY
    • Antipsychtoics
    • Muscle stiffness; high fever
    • Sweating tremors, confusion
    • Unstable BP & HR
  42. Typical antipsychs
    • D2 receptor
    • Higher risk of extrapyramidal se
  43. Risperidone
    • MOST LIKELY 2 INDUCE HYPERPROLACTINEMIA
    • Im SHOTS
    • Increased extrapyramil
    • Antypical; fx like typical >6mg
  44. Seroquel
    • Drug of choice if psychosis and parkinsons
    • Most likely to cause orthostatic hypoT
  45. Geodon
    • QT prolongation
    • No assoc wt gain
    • Absorption increased w/ food
  46. Abilify
    • Not assoc with wt gain
    • No qt prolong; low EPS; low sedation
  47. Clozaril
    • Incr risk seizures
    • Reserved for resistant pts
  48. Fanapt
    • Tirrate over 4 days
    • Qt prolongation
  49. Saphris
    Sublingual
  50. Latuda
    • Must administer w/ food
    • No qt prolongation
  51. Extrapyramidal side effects
    • Acute dystonia
    • Parkinson syndrome
    • akathisia
    • tx: benztropine; trihexyphenidyl; diphenhydramine
    • propranolol
    • amantadine
  52. Busprione
    • Good augmentation
    • No sedation
    • Reduce anxiety
  53. benzodiazapines
    • insomnia, parasomnias; anxiety tx
    • valiu; Ativan; xanx
    • ~~~"PAM"
    • Flumazenil reverses effects
  54. social anxiety tx
    pharm & therapy: behavioral/cognitive methods
  55. GAD tx
    THERAPY, PHARM AND SOCIAL SUPPORTIVE; time consuming
  56. Specific phobia tx
    behavior therapy: systematic and intesnive; Virtual therapy; supportive
  57. major neurocognitive tx
    • tx treatable; psychosocial ;
    • pharm: aricept; exelon; remiryl & cognex to tx alzheimers;
    • AVOID ANTICHOLINERGIC
  58. MDD
    • antidepressants; psychotherapies;
    • electroconvulsive therapy;
    • hospitalization; phototherapy
  59. persistent depressive
    • complex d/2 multiple contributing factors;
    • may require multiple approaches simultaneously
  60. PMDD
    • hormonal tx; antidepress/anxiety;
    • therapy, diet, exercise, support grps
  61. bipolar/cyclothmia tx
    • pharm w/ mood stabilizers ie LITHIUM
    • anticonvulsants ( valporic acid, carbamazepine, oxcarbazepine & lamotrigine) antidepressants, benzos and anti psychs prn sx control
    • ECT effetive in severe depression/mania
  62. OCD
    • FLUVOXAMINE
    • many pt reluctant; behavioral +meds:
    • clomipramine; mood stabilizers;
  63. HAORDING
    MOST EFFECTIVE=CBT
  64. OCD PD
    GROUP AND COG BEHAVIOR THEYAPY
  65. Avoidant
    • Psychotherapy
    • Group therapy
    • Tx depression/anxiety
  66. Paranoid pd
    • PSYCHOTHERAPY
    • Antianxiety (orap)
  67. Dependant
    • Psychotherapy
    • Meds for sx
  68. Pain disorder
    • NO NARCOTICS
    • SSRIS most effective
    • Psychotherapy
    • Cog therapy
    • Biofeedback
  69. Narcolepsy
    • reginmen of forced naps;
    • PROVIGIL to reduce sleep attacks
    • TCAs/SSRI to reduce cataplexy
  70. Hypersomnia
    PROVIGIL: wake-promoting substance
  71. Insomnia
    • pharm: bze & hynotics;
    • OTC sleep aids;
    • CBT;
    • universal sleep hygiene; relaxation & biofeedback
  72. dissociative ident
    • therapy: wide range of interventions;
    • pharm: prn for sx and comorgid;
    • ECT; adjunct therapies
    • EMDR
  73. Depersonal/real
    SSRIs may be beneficial; therapies;
  74. Dissociative amnesia
    cognitive theray; hypnosis; somatic tx; groupt therapy
  75. narcissitic
    • meds4 sx tx (lithium)
    • psychotherapy challenging: avoid self-apprecation or critizing pt
  76. histrionic
    • no meds; comorbid MDD;
    • group therapy and CBT effective
  77. no benzos
    borderline pd
  78. antisocial pd
    psychotherapy good in hospital settingl group therapy in jails; meds tx symptoms
  79. requires higher levels Prozac
    • bulimia
    • outpt; antidepresant
    • CBT and phychodynamic therapy
  80. Anorexia
    • hospitalization; in or out pt;
    • CBT psychodynamically oriented; family;
    • NO MEDS
  81. First-line major depression tx
    • SSRI
    • SNRI
    • Buproion
  82. Only SSRI FDA for MDD children
    Prozac
  83. Antidepressant least likely to cause sexual SE
    Bupropion
  84. DOC bipolar maintenance tx
    Lithium
  85. Long acting injectable antipsych bipolar tx
    Risperidone
  86. Not monotherapy for bipolar
    Citalopram
  87. 2nd gen antipsych warning label
    Hyperglycemia
  88. Anti psych improves +, - and cog sx
    Quetiapine(Seroquel)
  89. WBC and ANC clozapine values
    • WBC>3500
    • ANC>2000/mm3
  90. Ssris effective tx for
    • GAD
    • OCD
    • PTSD
    • Panic disorder
  91. PCOS assoc w.
    Depakote
  92. AE lithium?
    Increased urination
  93. Black box warning liver failure
    Nefazodone/ serzone
  94. Antidepressant inhgits NE and 5-HT reuptake
    • TCA
    • SNRI
  95. Ssri electrolyte abnormality
    hyponatremia

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