PMHNP Psychopharm Exam 6 2024
NSAIDS - Increases Lithium Levels
Reliability - consistency of measurement
Reliability is another term for consistency. If one person takes the same personality test
several times and always receives the same results, the test is reliable.
internal validity - Refers to how well an experiment is done,
Was it done RIGHT
extent to which we can draw cause-and-effect inferences from a study
Qualitative - Data in the form of recorded descriptions rather than numerical measurements.
Quantitative - relating to, measuring, or measured by the quantity of something rather than its
quality.
Data in numbers
Biggest concern with EMR - Privacy confidentiality
Scope of Practice - STATE
Standards of Practice - ANA
The standard of practice limitations imposed upon a healthcare provider are based on local
regulations and which of the following elements?
Beck Depression - 0-9: indicates minimal depression
10-18: indicates mild depression
19-29: indicates moderate depression
30-63: indicates severe depression.
Hamilton Depression Scale - TOTAL ITEMS 1 TO 17: _______________
0-7=Normal
8 - 13 = Mild Depression
14-18 = Moderate Depression
19 - 22 = Severe Depression
> 23 = Very Severe Depression
PHQ9 - Score Depression severity Comments
0-4 Minimal depression
5-9 Mild depression
10-14 Moderate depression
15-19 Moderate Severe depression
20-27 Severe
,0-4 Minimal or none Monitor; No TX
5-9 Mild Use clinical judgment (symptom duration, functional impairment) to determine
necessity of treatment
10-14 Moderate
15-19 Moderately severe
Warrants active treatment with psychotherapy, medications, or combination
20-27 Severe
Anorexia/Bulimia Admission to Hospital for Pediatrics - American Academy of Pediatrics
Criteria for Inpatient Hospitalization in Eating Disorders
Anorexia nervosa
Heart rate < 50 beats/min daytime; < 45 beats/min nighttime
Systolic blood pressure < 90 mm Hg
Orthostatic changes in pulse (> 20 beats/min) or blood pressure (> 10 mm Hg)
Arrhythmia
Temperature < 96°F
< 75% ideal body weight or ongoing weight loss despite intensive management
Body fat < 10%
Refusal to eat
Failure to respond to outpatient treatment
Bulimia nervosa
Syncope
Serum potassium < 3.2 mmol/L
Serum chloride < 88 mmol/L
Esophageal tears
Cardiac arrhythmias including prolonged QTc
Hypothermia
Suicide risk
Intractable vomiting
Hematemesis
Failure to respond to outpatient treatment
Anorexia Admission -
How long does antidepressants work - 4-6 weeks
Yalom - Yalom's eleven therapeutic factors that influence change and healing in group
therapy:
1. The instillation of hope creates a feeling of optimism.
2. Universality helps group members realize that they are not alone in their impulses,
problems, and other issues.
,3. Imparting information helps to educate and empower people with knowledge pertaining to
their specific psychological situation.
4. Altruism allows clients to gain a sense of value and significance by helping other group
members.
5. Corrective recapitulation provides for the resolution of family and childhood events within
the safety of the group family.
6. Socializing techniques promote social development, tolerance, empathy, and other
interpersonal skills.
7. Through imitative behavior group members learn to adopt the coping strategies and
perspectives of other group members.
8. Interpersonal learning teaches clients how to develop supportive interpersonal
relationships.
9. Group cohesiveness gives members a sense of acceptance, belonging, value, and security.
10. Catharsis releases suppressed emotions and promotes healing by disclosing information to
group members.
11. Existential factors incorporate learning how to just exist as part of something larger than
oneself. This factor brings a client into the awareness that life will continue on, with pain,
death, sadness, regret, and joy. By living existentially, clients learn how to accept these
conditions without escaping from them. Instead, they learn how to live with them and through
them.
Tegretol - Check ANC and WBC- Causes Agranulocytosis
Delirium versus Dementia - Delirium is Acute
Dementia is progressive
Steroids Trigger - Mania
Positive Trendelenburg test - REFER to Ortho
A positive Trendelenburg test usually indicates weakness in the hip abductor muscles: gluteus
medius and gluteus minimus.[1] These findings can be associated with various hip
abnormalities such as congenital hip dislocation, rheumatic arthritis, osteoarthritis.
Tegretol and Erythromycin - Erythromycin inhibitor. You would decrease Tegretol.
Erythromycin would causes toxic Tegretol levels.
CYP Inducers
BULLSHIT CRAP GPS - Decrease other medication
Barbituates
St. Johns Wart
, Carbamazepine
Rifampin
Alcohol
Phentoin
Griseofluvin
Phenobarbital
Sulfonyureas
CYP Inhibitors
SICKFACE.COM - Sodium Valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythromycin
Sulfonamides
Cipro
Omeprazole
Metronidazole
Carb and Barb inducers - Decrease Coumadin
Depakote and Disulfram Inhibitors - Increase Coumadin
Nicotine Inducer-1A - Decreases/metabolizes Zyprexia quicker
GAL (Gabapentin, Acamprosate, Lithium) - Renally Metabolized
STOP SMOKING - Decrease Zyprexia
NSAIDS and ACE inhibitors - Increase Lithium Levels
Nigrostriatal pathways - EPS
Dilated Pupils and Hypertension - Opiate Withdrawal
Behavioral Therapy - For a Child Who Bed Wets
DDVAP - Decreases amount of urine
OTL (Oxazepam, Temazepam, Lorazepam) - Metabolized outside the liver by conjugation.
1/2 lives are the same even with advanced liver disease
Negligence - Autonomy-Independent
Justice -Fair
Beneficence- Do good
Non-maleficence-Do no harm
Validity-Faithful
NSAIDS - Increases Lithium Levels
Reliability - consistency of measurement
Reliability is another term for consistency. If one person takes the same personality test
several times and always receives the same results, the test is reliable.
internal validity - Refers to how well an experiment is done,
Was it done RIGHT
extent to which we can draw cause-and-effect inferences from a study
Qualitative - Data in the form of recorded descriptions rather than numerical measurements.
Quantitative - relating to, measuring, or measured by the quantity of something rather than its
quality.
Data in numbers
Biggest concern with EMR - Privacy confidentiality
Scope of Practice - STATE
Standards of Practice - ANA
The standard of practice limitations imposed upon a healthcare provider are based on local
regulations and which of the following elements?
Beck Depression - 0-9: indicates minimal depression
10-18: indicates mild depression
19-29: indicates moderate depression
30-63: indicates severe depression.
Hamilton Depression Scale - TOTAL ITEMS 1 TO 17: _______________
0-7=Normal
8 - 13 = Mild Depression
14-18 = Moderate Depression
19 - 22 = Severe Depression
> 23 = Very Severe Depression
PHQ9 - Score Depression severity Comments
0-4 Minimal depression
5-9 Mild depression
10-14 Moderate depression
15-19 Moderate Severe depression
20-27 Severe
,0-4 Minimal or none Monitor; No TX
5-9 Mild Use clinical judgment (symptom duration, functional impairment) to determine
necessity of treatment
10-14 Moderate
15-19 Moderately severe
Warrants active treatment with psychotherapy, medications, or combination
20-27 Severe
Anorexia/Bulimia Admission to Hospital for Pediatrics - American Academy of Pediatrics
Criteria for Inpatient Hospitalization in Eating Disorders
Anorexia nervosa
Heart rate < 50 beats/min daytime; < 45 beats/min nighttime
Systolic blood pressure < 90 mm Hg
Orthostatic changes in pulse (> 20 beats/min) or blood pressure (> 10 mm Hg)
Arrhythmia
Temperature < 96°F
< 75% ideal body weight or ongoing weight loss despite intensive management
Body fat < 10%
Refusal to eat
Failure to respond to outpatient treatment
Bulimia nervosa
Syncope
Serum potassium < 3.2 mmol/L
Serum chloride < 88 mmol/L
Esophageal tears
Cardiac arrhythmias including prolonged QTc
Hypothermia
Suicide risk
Intractable vomiting
Hematemesis
Failure to respond to outpatient treatment
Anorexia Admission -
How long does antidepressants work - 4-6 weeks
Yalom - Yalom's eleven therapeutic factors that influence change and healing in group
therapy:
1. The instillation of hope creates a feeling of optimism.
2. Universality helps group members realize that they are not alone in their impulses,
problems, and other issues.
,3. Imparting information helps to educate and empower people with knowledge pertaining to
their specific psychological situation.
4. Altruism allows clients to gain a sense of value and significance by helping other group
members.
5. Corrective recapitulation provides for the resolution of family and childhood events within
the safety of the group family.
6. Socializing techniques promote social development, tolerance, empathy, and other
interpersonal skills.
7. Through imitative behavior group members learn to adopt the coping strategies and
perspectives of other group members.
8. Interpersonal learning teaches clients how to develop supportive interpersonal
relationships.
9. Group cohesiveness gives members a sense of acceptance, belonging, value, and security.
10. Catharsis releases suppressed emotions and promotes healing by disclosing information to
group members.
11. Existential factors incorporate learning how to just exist as part of something larger than
oneself. This factor brings a client into the awareness that life will continue on, with pain,
death, sadness, regret, and joy. By living existentially, clients learn how to accept these
conditions without escaping from them. Instead, they learn how to live with them and through
them.
Tegretol - Check ANC and WBC- Causes Agranulocytosis
Delirium versus Dementia - Delirium is Acute
Dementia is progressive
Steroids Trigger - Mania
Positive Trendelenburg test - REFER to Ortho
A positive Trendelenburg test usually indicates weakness in the hip abductor muscles: gluteus
medius and gluteus minimus.[1] These findings can be associated with various hip
abnormalities such as congenital hip dislocation, rheumatic arthritis, osteoarthritis.
Tegretol and Erythromycin - Erythromycin inhibitor. You would decrease Tegretol.
Erythromycin would causes toxic Tegretol levels.
CYP Inducers
BULLSHIT CRAP GPS - Decrease other medication
Barbituates
St. Johns Wart
, Carbamazepine
Rifampin
Alcohol
Phentoin
Griseofluvin
Phenobarbital
Sulfonyureas
CYP Inhibitors
SICKFACE.COM - Sodium Valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythromycin
Sulfonamides
Cipro
Omeprazole
Metronidazole
Carb and Barb inducers - Decrease Coumadin
Depakote and Disulfram Inhibitors - Increase Coumadin
Nicotine Inducer-1A - Decreases/metabolizes Zyprexia quicker
GAL (Gabapentin, Acamprosate, Lithium) - Renally Metabolized
STOP SMOKING - Decrease Zyprexia
NSAIDS and ACE inhibitors - Increase Lithium Levels
Nigrostriatal pathways - EPS
Dilated Pupils and Hypertension - Opiate Withdrawal
Behavioral Therapy - For a Child Who Bed Wets
DDVAP - Decreases amount of urine
OTL (Oxazepam, Temazepam, Lorazepam) - Metabolized outside the liver by conjugation.
1/2 lives are the same even with advanced liver disease
Negligence - Autonomy-Independent
Justice -Fair
Beneficence- Do good
Non-maleficence-Do no harm
Validity-Faithful
