Antidepressants | Mood Stabilizers | Side Effects of Psychiatric Meds | Antipsychotics | Child Psychiatry |
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What is Prozac (fluoxetine)
This antidepressant has the longest half life of all of the antidepressants we use.
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What is Lithium.
This is the only mood stabilizer indicated for the prevention of suicidal ideation/attempt.
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What is an EKG.
Before starting an any psychiatric you should obtain this test.
::bonus:: why? |
Mesolimbic.
Mesocortical, tuberinfundibular, Nigrostriatal
Which area of the brain is responsible for positive psychotic symptoms and how do antipsychotics target this area?
::bonus:: which areas are responsible for negative symptoms and side effects? |
What is fluoxetine, sertraline, escitalopram
What are the only three SSRIs approved for use in pediatric depression (there are 4 but one you don't use).
::bonus:: why should we not be using Paxil in kids (but actually ever)? |
What is Lexapro (escitalopram)
SSRIs (and may other psych meds) have interactions with other medications because they are mainly metabolized by this receptor.
::bonus:: Name an SSRI that has minimal interactions ::bonus:: Name a blood pressure medication that you need to be careful with due to interactions with Prozac |
What is kidney function.
When starting Lithium what do you need to check first?
::bonus:: how often do you check blood levels inpatient? ::bonus:: what is a therapeutic lithium level? |
What is serotonin syndrome.
A patient comes in with abrupt onset of facial flushing, increased tone, hyperreflexia, mydriasis, tachy, HTN, and hyperthermia. They are likely suffering from this.
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Specificity of dopamine antagonism. Patient's with parkinson's.
What is the difference between a typical and an atypical antipsychotic? When do we not use an antipsychotic for psychosis?
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What are aripiprazole, risperidone, olanzapine
These are three meds approved for treatment of psychosis in pediatric adolescents.
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What is Wellbutrin (Buproprion)
This antidepressant is indicated more strongly for atypical depression.
::bonus:: Name two other indications for this medication ::bonus:: Name at least two patient populations that wouldn't be appropriate for this med |
What is hepatic impairment.
This is a relative (or absolute depending who you ask) contraindication to starting Depakote.
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What is NMS
Patient presents with gradually worsening stiffness, hyperthermia, tachy, HTN, hyporeflexia, and normal pupils. They are likely suffering from this.
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Haldol, Zyprexa, Geodon. IM available.
What antipsychotics can you use emergently for schizophrenic agitation? Why?
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What is PTSD
A child says they're seeing shadow figures out of the corner of their eye and voices inside their head telling them that they're worthless. These symptoms are indicative of this disorder.
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What is inhibition of the SERT transporter and eventual downregulation of the 5HT1a receptors over time. Neurotrophic effects via increased BDNF.
These are two ways that SSRIs and SNRIs work physiologically to alleviate depression/anxiety (be specific).
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YES. CHECK A LEVEL THEN YES.
A pregnant patient with bipolar disorder comes to your clinic asking if she should continue her lithium. She has had two manic episodes in the last two years. What do you tell her?
::bonus:: what fetal defect do we sometimes see with it? ::bonus:: what is the pathophysiology of that defect? |
Falls, medication interactions, dosing and elimination, bleeds
Name three reasons you need exercise caution when starting antidepressants in the elderly.
::bonus:: how can you use unintended effects of meds to produce intended effects in special populations like the elderly? |
Abilify, geodon, Latuda, Lamictal
Name at least two ~weight neutral antipsychotic
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That the inattention/hyperactivity is consistent across multiple contexts. GAD/MDD/ODD/DMDD
A parent comes to your office and wants you to start stimulant therapy for their kid due to ADHD symptoms. What aspect about the symptoms do you need to know to clarify the diagnosis? What could be a differential diagnosis? Why is it important to know?
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What is tramadol and linezolid.
This pain medication and this antibiotic should be used in caution in patients already on serotonergic agents.
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What is depakote
A patient comes in with mania and a history of aggression of agitation, sometimes even at baseline. What med is most appropriate?
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Metabolic disturbances, sedation, akathisia, NMS, cardiotoxicity, sudden death
Seizures, agranulocytosis, myocarditis/cardiomyopathy, sialorrhea
Name three major side effects caused by antipsychotics that need to be monitored when starting one. Name three that we particularly worry about with Clozapine.
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Eat 500 calories with each dose.
What do you need to remember to tell patients when starting Latuda (lurasidone) and Geodon (ziprasidone)
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Constipation/bed wetting
Name a physical symptom, seemingly unrelated to psychiatry but whose proper completion is necessary for independent living, that indicates you should take time to assess psychiatric safety of a child.
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