Dr. Cole Remediation Guide D345 OA Attempt 2
Remediation:
1. Group drugs in each class into tables. [using the index of one of the
pharmacology books like Medication Fact Book or Stahl’s Prescriber’s
Guide].
1. List the Mechanism of action of the drug class.
2. Compare and contrast each of the drugs [which ones are similar;
what’s different]
3. Consider and study why you might choose one drug over another.
1. Completed in the Comprehensive Study Guide
2. Make a table for all the main psychiatric diagnoses [ADHD, MDD,
GAD, PTSD, etc.].
1. List every single drug that can be used for this diagnosis and
how it works [Mechanism of action MOA].
1. Partial in comprehensive Guide. Redo the first line, second
line, of f labels, etc. In the comprehensive guide.
2. ADHD: Stimulant. Non stimulant. CBT. Mood stabilizer
augmentation.
3. MDD: SSRI First. SNRI. TCA/Atypical/MAOI. Of f label
augmentation(Wellbutrin) and mood stabilizers.
4. GAD: Acute: Benzo. Chronic SSRI first line.
5. PTSD: Mirtazapine of f label. SSRI first line. Prazosin(if dreams)
as augmentation.
6. Bipolar: Mood stabilizers. Antiepileptics. Antipsychotics(of f
label) and FDA.
7. Schizophrenia. Antipsychotics. Mood stabilizers.
8. Insomnia
[using the index of one of the pharmacology books like Medication Fact
Book or Stahl’s Prescriber’s Guide].
, 1. Note what is a special consideration about certain drugs
in each class.
2. List any labs that should be drawn for this drug or drug class.
3. Highlight the ones that are actually FDA approved for the
condition [much of what PMHNPs and psychiatrists do is off-
label – not FDA approved, but evidence-based].
1. In the comprehensive study guide sent.
3. Think in algorithms – how do you treat depression? What are the first
line and second line treatments?
1. SSRI. SNRI(two failed SSRI), TCA and atypical(depends which
responses and comorbidities). Of f Labels.
What do you do next if it is not working well or not at all [increase, change,
add another med???
Depends on the med. If SSRI or antipsychotic. May not be effective
immediately. Time for peak response. Augment tx when dosing gets too high
or switch med.
4. List all drugs contraindicated/or with precautions in geriatrics and
why?
1. Benzo and Z drugs. Xanax and Ambien can increase risk of falls,
confusion, sedation, and paradoxical reactions.
2. TCA: sedation and blood pressure drop. Fall risk.
3. Demerol: confusions/seizures.
4. Benadryl: Drowsy, confusion, and memory issues.
5. Dementia is black box. Venous thromboembolism, falls,
fractures, death, stroke.
5. List all drugs contraindicated/or with precautions in pediatrics and
why?
1. Monitor for increased SI in all meds. Antidepressants.
Ziprasidone(Geodon) :QT interval.
2. Antipsychotics with metabolic risks.
Remediation:
1. Group drugs in each class into tables. [using the index of one of the
pharmacology books like Medication Fact Book or Stahl’s Prescriber’s
Guide].
1. List the Mechanism of action of the drug class.
2. Compare and contrast each of the drugs [which ones are similar;
what’s different]
3. Consider and study why you might choose one drug over another.
1. Completed in the Comprehensive Study Guide
2. Make a table for all the main psychiatric diagnoses [ADHD, MDD,
GAD, PTSD, etc.].
1. List every single drug that can be used for this diagnosis and
how it works [Mechanism of action MOA].
1. Partial in comprehensive Guide. Redo the first line, second
line, of f labels, etc. In the comprehensive guide.
2. ADHD: Stimulant. Non stimulant. CBT. Mood stabilizer
augmentation.
3. MDD: SSRI First. SNRI. TCA/Atypical/MAOI. Of f label
augmentation(Wellbutrin) and mood stabilizers.
4. GAD: Acute: Benzo. Chronic SSRI first line.
5. PTSD: Mirtazapine of f label. SSRI first line. Prazosin(if dreams)
as augmentation.
6. Bipolar: Mood stabilizers. Antiepileptics. Antipsychotics(of f
label) and FDA.
7. Schizophrenia. Antipsychotics. Mood stabilizers.
8. Insomnia
[using the index of one of the pharmacology books like Medication Fact
Book or Stahl’s Prescriber’s Guide].
, 1. Note what is a special consideration about certain drugs
in each class.
2. List any labs that should be drawn for this drug or drug class.
3. Highlight the ones that are actually FDA approved for the
condition [much of what PMHNPs and psychiatrists do is off-
label – not FDA approved, but evidence-based].
1. In the comprehensive study guide sent.
3. Think in algorithms – how do you treat depression? What are the first
line and second line treatments?
1. SSRI. SNRI(two failed SSRI), TCA and atypical(depends which
responses and comorbidities). Of f Labels.
What do you do next if it is not working well or not at all [increase, change,
add another med???
Depends on the med. If SSRI or antipsychotic. May not be effective
immediately. Time for peak response. Augment tx when dosing gets too high
or switch med.
4. List all drugs contraindicated/or with precautions in geriatrics and
why?
1. Benzo and Z drugs. Xanax and Ambien can increase risk of falls,
confusion, sedation, and paradoxical reactions.
2. TCA: sedation and blood pressure drop. Fall risk.
3. Demerol: confusions/seizures.
4. Benadryl: Drowsy, confusion, and memory issues.
5. Dementia is black box. Venous thromboembolism, falls,
fractures, death, stroke.
5. List all drugs contraindicated/or with precautions in pediatrics and
why?
1. Monitor for increased SI in all meds. Antidepressants.
Ziprasidone(Geodon) :QT interval.
2. Antipsychotics with metabolic risks.
