PAEA Psychiatry EOR Topics Questions and
Answers| Latest Update
what is the recommended tx for bipolar disorders? -mood stabilizers: lithium 1st line
-anticonvulsants: valproic acid/Depakote, carbamazepine/Tegretol, or lamotrigine/Lamictal
-antipsychotics: haloperidol/Haldol or SGAs
-antidepressants: SSRIs, TCAs, MAOIs, ECT (although these can induce mania!)
-therapy: CBT
what is the tx for anorexia nervosa? hospitalization if <75% ideal body wt or w/
electrolyte imbalances (risk of arrhythmias), psychotherapy, supervised meals, wt monitoring,
pharmacotherapy- SSRIs if depressed, SGAs help w/ wt gain (metabolic side effects)
what is the tx for bulimia nervosa? CBT or fluoxetine/Prozac (reduces binge-purge cycle)
what is the tx for schizophrenia? 1st line: SGA (2nd gen antipsychotics aka atypicals):
quetiapine/Seroquel, olanzapine/Zyprexa, clozapine/Clozaril, loxapine/Loxatane,
risperidone/Risperdal, ziprasidone/Geodon, aripiprazole/Abilify, paliperidone/Invega,
iloperidone/Fanapt, asenapine/Saphris, lurasidone/Latuda
2nd line: FGAs: chlorpromazine/Thorazine, thioridazine/Mellarill, fluphenazine/Prolixin,
haloperidol/Haldol, pimozide/Orap, thiothixene/Navaine, perphenazine/Trilafon,
trifluoperazine/Stelazine
others: ativan, benadryl, etc.
,what labs should be drawn before starting tx for bipolar d/o? -thyroid (lithium can cause
hypothyroidism)
-renal fxn (lithium can decrease)
-pregnancy test (all but lamotrigine are teratogenic)
-hepatic fxn (all anticonvulsants can alter)
-CBC w/ diff (blood dyscrasias)
what medication class used to treat anxiety has the most severe withdrawal symptoms of tremor,
anxiety, restlessness, n/v, seizure, and cardiac arrest? list them barbituates: thiopental,
pentobarbital, secobarbital, butalbital, amobarbital, phenobarbital
"-tal"
*these work in the same way benzos do by binding to GABA receptors and causing
hyperpolarization and thus decreased APs
what medication used to treat chronic anxiety competes with histamine with the H1 receptor in
the GI tract, blood vessels and respiratory tract? what are some ADRs?
hydroxyzine/Visteril
ADRs: drowsiness, xerostomia, respiratory depression, QT prolongation
, what meds are considered 1st line in treating depressive disorders like MDD and PDD?
SSRI's (fluoxetine/Prozac, sertraline/Zoloft, paroxetine/Paxil, citalopram/Celexa,
escitalopram/Lexapro, fluvoxamine/Luvox)
what mood stabilizer or anticonvulsant used to tx bipolar d/o can cause SJS/TENS if not titrated
slowly enough when starting? lamotrigine/Lamictal
what will be found on PE and labs of a bulimia nervosa pt? PE: teeth pitting or enamel
erosion (from vomiting), russell's sign (calluses on dorsum of hand from induced vomiting),
parotid gland hypertrophy
labs: metabolic alkalosis from vomiting, hypokalemia, hypomagnesemia
what will be seen on PE and labs of an anorexia nervosa pt? *PE*: emaciation,
hypotensions, bradycardia, skin/hair changes (lanugo- blonde peach fuzz), dry skin, salivary
gland hypertrophy, ameorrhea, arrhythmias, osteoporosis
*labs*: leukocytosis, leukopenia, anemia, hypokalemia, inc BUN (dehydration), hypothyroidism
which antidepressant can cause worsening of glaucoma? duloxetine/Cymbalta
which antidepressants can cause QT prolongation? which is the worst? ALL except for
*combined SSRIs* (vilazodone/Viibryd, vortioxetine/Brintellex), *MAOIs*
(Isocaboxazid/Marplan, phenelzine/Nardil, tranylcypromine/Parnate, selegiline transdermal
patch), and *"fringe drugs"* (buproprion/Wellbutrin, mirtazapine/Remeron, trazodone)
*citalopram*/Celexa (SSRI) has a BBW for QT prolongation
Answers| Latest Update
what is the recommended tx for bipolar disorders? -mood stabilizers: lithium 1st line
-anticonvulsants: valproic acid/Depakote, carbamazepine/Tegretol, or lamotrigine/Lamictal
-antipsychotics: haloperidol/Haldol or SGAs
-antidepressants: SSRIs, TCAs, MAOIs, ECT (although these can induce mania!)
-therapy: CBT
what is the tx for anorexia nervosa? hospitalization if <75% ideal body wt or w/
electrolyte imbalances (risk of arrhythmias), psychotherapy, supervised meals, wt monitoring,
pharmacotherapy- SSRIs if depressed, SGAs help w/ wt gain (metabolic side effects)
what is the tx for bulimia nervosa? CBT or fluoxetine/Prozac (reduces binge-purge cycle)
what is the tx for schizophrenia? 1st line: SGA (2nd gen antipsychotics aka atypicals):
quetiapine/Seroquel, olanzapine/Zyprexa, clozapine/Clozaril, loxapine/Loxatane,
risperidone/Risperdal, ziprasidone/Geodon, aripiprazole/Abilify, paliperidone/Invega,
iloperidone/Fanapt, asenapine/Saphris, lurasidone/Latuda
2nd line: FGAs: chlorpromazine/Thorazine, thioridazine/Mellarill, fluphenazine/Prolixin,
haloperidol/Haldol, pimozide/Orap, thiothixene/Navaine, perphenazine/Trilafon,
trifluoperazine/Stelazine
others: ativan, benadryl, etc.
,what labs should be drawn before starting tx for bipolar d/o? -thyroid (lithium can cause
hypothyroidism)
-renal fxn (lithium can decrease)
-pregnancy test (all but lamotrigine are teratogenic)
-hepatic fxn (all anticonvulsants can alter)
-CBC w/ diff (blood dyscrasias)
what medication class used to treat anxiety has the most severe withdrawal symptoms of tremor,
anxiety, restlessness, n/v, seizure, and cardiac arrest? list them barbituates: thiopental,
pentobarbital, secobarbital, butalbital, amobarbital, phenobarbital
"-tal"
*these work in the same way benzos do by binding to GABA receptors and causing
hyperpolarization and thus decreased APs
what medication used to treat chronic anxiety competes with histamine with the H1 receptor in
the GI tract, blood vessels and respiratory tract? what are some ADRs?
hydroxyzine/Visteril
ADRs: drowsiness, xerostomia, respiratory depression, QT prolongation
, what meds are considered 1st line in treating depressive disorders like MDD and PDD?
SSRI's (fluoxetine/Prozac, sertraline/Zoloft, paroxetine/Paxil, citalopram/Celexa,
escitalopram/Lexapro, fluvoxamine/Luvox)
what mood stabilizer or anticonvulsant used to tx bipolar d/o can cause SJS/TENS if not titrated
slowly enough when starting? lamotrigine/Lamictal
what will be found on PE and labs of a bulimia nervosa pt? PE: teeth pitting or enamel
erosion (from vomiting), russell's sign (calluses on dorsum of hand from induced vomiting),
parotid gland hypertrophy
labs: metabolic alkalosis from vomiting, hypokalemia, hypomagnesemia
what will be seen on PE and labs of an anorexia nervosa pt? *PE*: emaciation,
hypotensions, bradycardia, skin/hair changes (lanugo- blonde peach fuzz), dry skin, salivary
gland hypertrophy, ameorrhea, arrhythmias, osteoporosis
*labs*: leukocytosis, leukopenia, anemia, hypokalemia, inc BUN (dehydration), hypothyroidism
which antidepressant can cause worsening of glaucoma? duloxetine/Cymbalta
which antidepressants can cause QT prolongation? which is the worst? ALL except for
*combined SSRIs* (vilazodone/Viibryd, vortioxetine/Brintellex), *MAOIs*
(Isocaboxazid/Marplan, phenelzine/Nardil, tranylcypromine/Parnate, selegiline transdermal
patch), and *"fringe drugs"* (buproprion/Wellbutrin, mirtazapine/Remeron, trazodone)
*citalopram*/Celexa (SSRI) has a BBW for QT prolongation
