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lamotrigone is increased by - ANSWER valproate manic patient on lamotrigine develops facial rash ans sore throat. intervention? -ANSWER stop lamotrigine go to we
lancinating facial pain triggerd by minor stimuli. treated by : - ANSWER carbamazepineor gabapentin
DC carbamazepine when WBC IS < - ANSWER 3000 manic pt on carbamazepine and stabilized on clozapine. wbc < 3000. intervention: -ANSWER DC carbamazepine
pt on carbamazepine develops non-blanching rash, weakness and palor. what test toorder? - ANSWER cbc
erythromycin does what to carbamazepine - ANSWER raises levels can cause heartblock
carbamazepine causes : - ANSWER -dizziness more often than Li- hyponatremia
carbamazepine and rash - ANSWER maculopapular in 15% in the first few weeks topiramare se: - ANSWER kidney stones
migraine prophylactic - ANSWER vpa, topiramare treatment for juvenile myoclonic epilepsy - ANSWER vpa tx generalized tonic clonic sz - ANSWER vpa valproate SE - ANSWER hair loss, weight gain tx rapid cycling and mixed episodes - ANSWER VPA > Li neural tube defects caused by: - ANSWER vpa, cbz pt on paxil with new low na, lethargy, low bun, normal cr. next lab? - ANSWER urineosmolality - SIADH
GBS also called - ANSWER acute inflammatory polyneuropathy What drug increases paroxetine concentrations - ANSWER cimetidine do not prescribed fluoxetine with what medication - ANSWER phenelzine what is the SSRI most likely to have a discontinuation syndrome - ANSWER paroxetine paroxetine has mild anticholinergic activity due to: - ANSWER action on muscarinicreceptors
cimetidine does what to paroxetine concentrations - ANSWER increases
venlafaxine causes - ANSWER htn bupropion is least likely to cause - ANSWER sexual dysfunciton, orthostatichypotension, incrsae REM, low risk of weight gain
fluvoxamine, phenelzine and paroxeitne and clomipramine are good tx for - ANSWEROCD
psychosis in bupropion is due to - ANSWER elevated DA Urinary retention and blurred vision are - ANSWER muscarinic SE mirtazapine causes what throught what mech? - ANSWER weight gaine and sedationthrought H1 antagonism, low sexual SE
Abruptly stoppping venlafaxine = - ANSWER nausea, insomnia, anxiety, dizziness,"electric shocks"
venlafaxine targets - ANSWER 5ht and NE reuptake inhibitionand is structurally aphenylethylamine
trazodone can be used in - ANSWER long-term insomnia and elderly with dementia preferred TCA in elderly with detectable blood levels: - ANSWER desipramine impipramine causing urinary retention tx? - ANSWER bethanechol amoxepine causes - ANSWER PD symptoms
Nortriptiline has a? - ANSWER curvilinear therapeutic window Death post TCA OD is usually from - ANSWER arrhytmia what should yuo monitor with TCA - ANSWER EKG for prolonged PR and QT TCA associated with what in children? - ANSWER sudden death, need EKG prior totreatment
clomipramine treats? - ANSWER OCD Doxepin has strongest - ANSWER antihistaminic effect amitriptyline commonly causes - ANSWER anticholinergic SE antichoinergic SE? - ANSWER dry mouth, blurred vision, constipation, urinary retention you should not use amitirptyline in - ANSWER acute angle glaucoma what causes orthostatic hypotension in TCAs? - ANSWER alpha 1 adrenergic blockade Pt fearful of eating in public and fears social scrutiny has failed high doses of SSRI,buspar, and BZD tx - ANSWER phenelzine
meperidine plus MAIO = - ANSWER lethal (hyperreflexia, HTN, coma) Pt on MAOI develops cold symptoms, starts pseudoephedrine -> - ANSWER HTN crisis
Clozapine has lease effect on? - ANSWER prolactin which has weakest affint for d2 receptor? - ANSWER clozapine cimetiidne does what to clozapine - ANSWER increases quetiapine is associated wiht? - ANSWER cataracts tx of choice for LBD or PD wiht VH? - ANSWER quetiapine IV haldol lowers? - ANSWER Mg levels -> torsades atypical black box? - ANSWER all cause death in elderly olanzepine has risk of - ANSWER DM and hyperglycemia CBZ does what to BZD levles? - ANSWER decrease diazepam accumulates with? - ANSWER repeated administration, avoid in renal failure triazolam has half life of? - ANSWER < 6 hrs which bzd has longest 1/2 life? - ANSWER flurazepam what is associated wiht bad abuse potential? - ANSWER time of onset to action which bzd is safe in elderly? - ANSWER lorazepam, no active metabolites
pt with liver failure should be given which bad? - ANSWER LOT = lorazepam, oxazepam,temazepam
most common SE of bzd - ANSWER sedation what reverses BZD - ANSWER flumazenil in pts with short-acting bad with breakthru anxiety? - ANSWER switch to clonazepam chronic bzd use is asociated wiht - ANSWER amnesian and decrease in REM anxious pt with pulmonary dz - ANSWER buspar tx severe performance anxiety - ANSWER propranolol tx Li toxicity - ANSWER hemodialysis Li toxicity? - ANSWER confusion, ataxia, dysarthria, seizures, nephortoxic, QTX prolong, ST depression
Pt on Li develops ALOC, dysarthria and ataxia after what? - ANSWER indomethacin what protects against SI? - ANSWER Li, clozapine, lamotrigine pregnant pt with BMD is stable on Li, d/c once and went manic, what to do? - ANSWERcontinue Li
Methadone + diazepam = - ANSWER greates amoutn of eupohria methadone has strong drug-drug with? - ANSWER HIV meds mother sees child killed in MVA now has 2 days of memory loss, insomnia, poor appetite,poor adls, sense of numbness, detachement and anxiety - ANSWER acute stress d/o
DDX of anxiety in ER - ANSWER PE worsening of depression/anxiety in chronically ill - ANSWER uncontrolled pain rapid cycling more common in - ANSWER females, associated with thyroid abno. ddx for cyclothymic? - ANSWER histrionic length of time for dx delusional - ANSWER 1 mo unreasonable belief that when challenged the patient is able to state it is possibly untrue- ANSWER overvalued idea
melancholic depression? - ANSWER lack of pleasure depression with interpersonal rejection sensitivy, leaden paralysis? tx? - ANSWERatypical , phenelzine
depression and heart dz? - ANSWER increase mortality from ischemic heart dz interferon and mood? - ANSWER depression , fatigue, cognitive issues
becks model of depression? - ANSWER evaluate distorted negative thoughts modle for depression? - ANSWER learned helplessness, principles of classicalconditioning
tx refractory depressiona nd catotonia - ANSWER ECT describe altered consciousness and focues attenint in dissociatve d/co - ANSWER"trance"
anorexics w/ purging and bulemia have - ANSWER low k, orthostasis, can be letahl anorexida dx = - ANSWER < 85% ideal body weight longest to restor after weight normalizines with eco? - ANSWER osteoporosis malingering has - ANSWER external incentive factitious has - ANSWER movtivation to assume sick role OCD has famililal links to - ANSWER tic d/op hearing voices doing a commentary or 2 voices arguing - ANSWER schneiderian 1strank
wome and schizophrenia? - ANSWER later onset, better prognosis
cannabis in urine - ANSWER 1 mo PC in urine - ANSWER 8 days ketamine causes - ANSWER eupohria, flying, social withdrawal, nystagmus acute caffine withdrawal - ANSWER HA how to determine pentobarb in detox - ANSWER pentobarb challeng wants cig after every meal - ANSWER enviromental trigger confusion, dry mouth, dialted and unresponsive pupils ,OD? - ANSWER benztropine,benadry or scopolamine
tx anticholinergid delirium - ANSWER physostig, halodl reward aspects of drugs? - ANSWER Nucleus accumbens Cocaine in urine - ANSWER 4 days PCP intox = - ANSWER nystagmus tach, HTN, paranoia, pressured speech, euphoria MC abuse substance wiht schizophrenia - ANSWER nicotine priot to naltrexone injection, use? - ANSWER naloxone
pupillary constriction - ANSWER heroin intox OD on codein, heroin, opiates.. - ANSWER constricted pupils, blue lips, crackes on lungexam, arrythmia
tx tylenol OD - ANSWER NAC in addition to aprent report of 7 y/o with hyperactivity since age 4 with difficulty sittingstill, problems with homework and not able to play quietly need a teacher's reprot - ANSWER conner and pressenc of 2 or more setting to dx adhd methyphen doest work now what - ANSWER dextroamphetamine adolescents with DC and ADHD - ANSWER tx buproprion on atomoxetine hyperactivity componeing of ADHD improves wiht - ANSWER age adults presnt with symptoms of ADHD tx with stim as child - ANSWER respond well tostim as adult
what is commonly comorbid with adhd - ANSWER depression tx of separation anxiety - ANSWER back to school anxiety and age - ANSWER separation decrsaes, gAD increases adolescents with depression and psychosis - ANSWER most likely BMD instead of sadness children with mdd may have - ANSWER irritable mood
