1. Seratonin & GABA are responsible for?
  2. Norepinephrine & Dopamine are responsible for what?
  3. The #1 complaint of people who take SSRIs is what?
    Decreased Libido (sex drive)

    -Gain Weight (appetite is increased)
  4. Common screening tool for Depression?
  5. 8 symptoms of Depression?
    • Sleep issues
    • Interests loss
    • Guilt
    • Energy low
    • Concentration poor
    • Appetite change
    • Psychomotor agitation
    • Suicidality
  6. Diagnosis for Major Depression?
    5 or more symptoms present most every day
  7. Diagnosis for moderate depression?
    At least 2-4 symptoms present most of the day
  8. What is the Black Box warning for antipsychotics & SSRIs?
    Increased risk of suicide
  9. Kava-kava & Valerian root are used for what 2 things?
    Anxiety & Insomnia
  10. Kava-Kava & Valerian root should not be mixed with what?
    • Benzodiazepines
    • Hypnotics
    • CNS depressants
  11. Asking a patient to spell a world backwards is known as what type of exam?
  12. MAOIs are rarely used due to their serious side effect with what type of food? Examples?
    High Tyramine (beer, cheese, wine, & fava beans)
  13. Antipsychotics lead to an increase in what?
    Obesity, DMII, hyperlipidemia, metabolic syndrome, hypothyroidism
  14. What herb can be used for Depression & menopausal symptoms?
    St. John’s Wart
  15. Major consideration if prescribing St. John’s wart?
    A lot of medication interactions
  16. When are hallucinations common?
    Between 16/30 years of age and patient has poor social skills and executive function
  17. Lone GGT elevation is a sign of what?
    Alcohol Abuse
  18. What AST/ALT ratio is suspicious for alcoholism?
  19. What is Karsakoff’s syndrome caused by?
    Chronic Thiamine Deficiency
  20. What should a patient be educated if on nicotine gum/patches?
    Do not smoke while using patches

    Do not use gum & patches both
  21. How many drinks a day are men/women allowed?
    • Men - 2
    • Women - 1
  22. Patients can smoke on what smoking cessation drug?
    Bupropion (Zyban)
  23. A complication from chronic alcohol abuse that causes a neurological disorder with signs that include hypotension, visual impairment, & coma.

    Korsakoff’s Syndrome

    Treated by high dose parenteral vitamins especially thiamine (vitamin B1)
  24. Smoking cessation should be discussed how often with patients?
    Every visit
  25. A patient presents with lanugo, peripheral edema (due to poor protein intake), weight loss >10%, and amenorrhea. What are you concerned for?
    Anorexia Nervosa
  26. What are patients with Anorexia Nervosa at high risk for?
  27. Why is Bupropion contraindicated in patients with anorexia?
    Increases seizure threshold
  28. What is a common side effect of Paroxetine (Paxil)?
    Erectile Dysfunction
  29. What do patients needs to know regarding Paroxetine (Paxil) when discontinuing the medication?
    It has a short half life & the patient should be weaned slowly from the medication

    Category D
  30. What is s good drug to start an older depressed patient who has a lot of medications on?
    Citalopram (Celexa) because it has less side effects than other SSRIs
  31. What 2 things are TCAs commonly used for?
    • Herpetic Neuralgia
    • Migraine Headache Prophylaxis
  32. First line medication for depression?
    • SSRI
    • -Sertaline (Zoloft)
    • -Escitalopram (Lexapro)
    • -Fluoxetine (Prozac)
    • -Paroxetine (Paxil)
  33. What is first line for depressive patients?
    Psychotherapy first
  34. Common side effect of SSRIs other than decreased libido? Why?
    GI side effects - nausea, vomitting, diarrhea, weight gain, sleepiness

    Seratonin receptors in gut.
  35. When starting SSRIs in the elderly what should you do with their starting dose of medication?
    1/2 the dose
  36. What do we know about treating depression in older adults?
    It may take them longer to get better than adolescents
  37. What type of depression medication should you not prescribe the elderly?
    TCAs because they cause anti-cholinergic side effects & can cause arrhythmias
  38. Which depression drug class can patients overdose on by consuming a large Amount of pills?
  39. What is the approach to treating bi-polar patients?
    Must treat both poles by prescribing a - mood stabilizer & anti-depressant
  40. What is bi-polar defined by?
    Depression + Manic Episodes
  41. What is the most common side effect of lithium therapy?
    Diabetes Insipidus (polydipsia/polyuria)
  42. What is typical after a person has a loved one die?
    Searching behavior where they hear the persons voice/see them but is not a psych illness, it will resolve
  43. What are the 4 Criteria even diagnosing anorexia nervosa?
    • -intense fear of weight gain
    • -weight below 85% of ideal body weight
    • -severe body image disturbance
    • -amenorrhea
  44. TCAs can be taken when to avoid side effects?
    Bed time (drowsiness)
  45. What lab must you always make sure to get in a newly diagnosed adolescent depressed patient?
    Urine Drug Screen
  46. When starting antidepressant in an older adult what should you always get as a baseline measure?
  47. What 4 labs should you get in an older adult with depression?
    • CBC
    • TSH
    • B12/Folate
    • Chem Panel
  48. How long must depression persist after delivery to be considered postpartum depression?
    >10 days (anything less is considered postpartum “blues”)
  49. What labs need to be monitored in patients who take atypical antipsychotics?
    Fasting BG, lipid profile & Weight (atypical antipsychotics increase risk of gaining weight)
Card Set