Georgette Review.
Native americans Correct answers ethnic group w/ the highest rate of SI
in the US
If cultural question Correct answers make an accommodation for them
even if against
polic
y
RESPECT also
important
contextualize their situation/clarify the meaning of their illness in
their culture
if it's a cultural syndrome, it's not mental illness--provide supportive
psychotherapy
Education w/ cultural consideration Correct answers teach education based
on cultural.
if multiple cultures present during education- provide multicultural
ethonospecific
assessment
parameters
Answering tips Correct answers if part of quesiton wrong, whole
question wrong.
If 3 of the same and one different usually answer is the one
that's different
Answering tips Correct answers Priority is airway, breathing,
circulation.
Then maslows heirchy-- safety, needs,
culture
then assessment before intervention if
needed.
don't choose to delegate, always chose to collaborate/do it
yourself
3 antipscyhotics that are least likely to cause wt gain Correct answers
lurasidone,
abilify, and ziprasidone
(geodon)
abilify least
sedating
Pt develops metabolic syndrome: Correct answers elevated A1C, lipid,
glucose,
waist hip to
ratio,
BMI
What do you do
first?
reduce calorie, exercise..if
not
then switch to lurasidone, abilify, or
geodon
,First psychotic episodes? Correct answers atypicals...especially IM
injections
fastest because
mode of
action
Zyprexa, Invega, Abilify or
Geodon
Normal TSH Correct answers 0.5 -
5.0
hyperthyroid Correct answers anxiety, irritable, heat intolerance, tachy,
moodincreased
loss, swings, wt
appetite
Hypothyroid Correct answers cold intolerance, lethargy, wt gain,
decreased lbido
Steven Johnson (lamictal, lamotrigine) Correct
answers Fever
ras
h
burning
eyes/mucosa
H
A
Lamictal Correct answers mood stabilizer that causes the least amount
of wt gain
Carbamazepine (tegretol) Correct answers also can cause SJS
or rash
especially in
asians
must screen for HLAB-1502 allele first for all asains (if positive, means at
increased
for risk
SJS, don't
give)
Which meds cause agranulocytosis Correct answers tegretol
AND clozaril
DC if ANC <1000 whether or not signs of
infection
monitor for signs of infection which indicate granulocytosis- fever, sore
throat, fatigue,
chills
.
Valproic Acid (depakote) Correct answers can
cause:
-spina
bifida
-hepatotoxicity (RUQ pain, reddish-brown urine- check
LFTS)
Signs of hepatotoxicity (depakote) level >150 Correct answers
confusion
disorientati
on
letharg
y
respiratory
depression
priority- D/c
depakote
get LFTs, ammonia levels --high ammonia causes
confusion
50-125, toxicity occurs if
>150
, pregnancy test Correct answers HCG human chorionic
gonadotropin
always check before placing on mood stabilizer for women childbearing
age (12-51)
Kava kava Correct answers herbal
supplement
taken for insomnia,
anxiety
MOST important is to check
LFTs
also drug drug interaction w/ kava and
benzos
Which meds can effect liver? Correct
answers BZN
TCA
Depakot
e
Lithium level Correct answers
0.6-1.2
If reaches 1.5- discontinue
lithum...
if 1.3 or 1.4---monitor for toxicity, but once reaches 1.5-
immediately d/c
Which drugs increase lithium levels Correct answers they reduce renal
clearance:
NSAID
s
hydrochlorothiazi
de
ACE
inhibitors
Also- dehydration/hyponatremia can increase lithium. Make sure they stay
hydrated.
Treatment of NMS Correct answers D/C
med
bromocriptine (parlodel)- D2
agonist
o
r
dantrolene- muscle relaxant (muscle
rigidity)
Serotonin syndrome Correct answers D/C
med
cyproheptadi
ne
When switching antidepressenats Correct answers wait 14 days when SSRI
-> MAOI
wait 5-6 wks from fluoxetine to
MAOI
Native americans Correct answers ethnic group w/ the highest rate of SI
in the US
If cultural question Correct answers make an accommodation for them
even if against
polic
y
RESPECT also
important
contextualize their situation/clarify the meaning of their illness in
their culture
if it's a cultural syndrome, it's not mental illness--provide supportive
psychotherapy
Education w/ cultural consideration Correct answers teach education based
on cultural.
if multiple cultures present during education- provide multicultural
ethonospecific
assessment
parameters
Answering tips Correct answers if part of quesiton wrong, whole
question wrong.
If 3 of the same and one different usually answer is the one
that's different
Answering tips Correct answers Priority is airway, breathing,
circulation.
Then maslows heirchy-- safety, needs,
culture
then assessment before intervention if
needed.
don't choose to delegate, always chose to collaborate/do it
yourself
3 antipscyhotics that are least likely to cause wt gain Correct answers
lurasidone,
abilify, and ziprasidone
(geodon)
abilify least
sedating
Pt develops metabolic syndrome: Correct answers elevated A1C, lipid,
glucose,
waist hip to
ratio,
BMI
What do you do
first?
reduce calorie, exercise..if
not
then switch to lurasidone, abilify, or
geodon
,First psychotic episodes? Correct answers atypicals...especially IM
injections
fastest because
mode of
action
Zyprexa, Invega, Abilify or
Geodon
Normal TSH Correct answers 0.5 -
5.0
hyperthyroid Correct answers anxiety, irritable, heat intolerance, tachy,
moodincreased
loss, swings, wt
appetite
Hypothyroid Correct answers cold intolerance, lethargy, wt gain,
decreased lbido
Steven Johnson (lamictal, lamotrigine) Correct
answers Fever
ras
h
burning
eyes/mucosa
H
A
Lamictal Correct answers mood stabilizer that causes the least amount
of wt gain
Carbamazepine (tegretol) Correct answers also can cause SJS
or rash
especially in
asians
must screen for HLAB-1502 allele first for all asains (if positive, means at
increased
for risk
SJS, don't
give)
Which meds cause agranulocytosis Correct answers tegretol
AND clozaril
DC if ANC <1000 whether or not signs of
infection
monitor for signs of infection which indicate granulocytosis- fever, sore
throat, fatigue,
chills
.
Valproic Acid (depakote) Correct answers can
cause:
-spina
bifida
-hepatotoxicity (RUQ pain, reddish-brown urine- check
LFTS)
Signs of hepatotoxicity (depakote) level >150 Correct answers
confusion
disorientati
on
letharg
y
respiratory
depression
priority- D/c
depakote
get LFTs, ammonia levels --high ammonia causes
confusion
50-125, toxicity occurs if
>150
, pregnancy test Correct answers HCG human chorionic
gonadotropin
always check before placing on mood stabilizer for women childbearing
age (12-51)
Kava kava Correct answers herbal
supplement
taken for insomnia,
anxiety
MOST important is to check
LFTs
also drug drug interaction w/ kava and
benzos
Which meds can effect liver? Correct
answers BZN
TCA
Depakot
e
Lithium level Correct answers
0.6-1.2
If reaches 1.5- discontinue
lithum...
if 1.3 or 1.4---monitor for toxicity, but once reaches 1.5-
immediately d/c
Which drugs increase lithium levels Correct answers they reduce renal
clearance:
NSAID
s
hydrochlorothiazi
de
ACE
inhibitors
Also- dehydration/hyponatremia can increase lithium. Make sure they stay
hydrated.
Treatment of NMS Correct answers D/C
med
bromocriptine (parlodel)- D2
agonist
o
r
dantrolene- muscle relaxant (muscle
rigidity)
Serotonin syndrome Correct answers D/C
med
cyproheptadi
ne
When switching antidepressenats Correct answers wait 14 days when SSRI
-> MAOI
wait 5-6 wks from fluoxetine to
MAOI
