Mental Health Quiz 8

Anhedonia Def

Decrease or lack of pleasure in what is normally pleasurable

Benzodiazepines (i.e., Lorazepam) (treats what and what, 4 meds, 6 side effects)

Treat anxiety, used to detox patients

-Diazepam (Valium)-Common to be used during seizure activity

-Lorazepam (Ativan)

-Alprazolam (Xanax)

-Clonazepam (Klonopin)

-Side Effects:

   -Physical dependence on drug

   -CNS depression, respiratory depression, psychosis, over sedation

   -Benzos withdrawal can be fatal so do not stop suddenly

Bipolar disorder (diagnosed when ?, Mania def, hypomania def, 2 things that are part of bipolar disorder, the 3 types of bipolar)

 -Diagnosed when a person’s mood fluctuates to extremes of mania and or depression

   -Mania- A distinct period during which mood is severely abnormal and persistently elevated, expansive, or irritability interferes with a person's ability to function.

   -Hypomania-Milder version of mania

-Depression

-Suicide risk-Associated with depressive episodes

-Types of Bipolar:

   -Bipolar I-One episode of mania with or without episodes of major depression. With or without psychosis.

   -Bipolar II-Hypomania alternates with depression.

   -Cyclothymia-Hypomania with mild episodes of depression.

Depression Treatment (9, 2 have def)

 SSRI

MOAI

SNRI

SNDI

TCA

SARI

Ketamine

Psychotherapy-Interpersonal therapy, behavior therapy, cognitive therapy.

TMS-Transcranial Magnetic Stimulator

SSRI 2 drugs 5 side effects

Safest

Sertaline (zoloft),

Fluvoxamine (Luvox).

Side Effects: HA, sex problem, agitation, N/V, High risk of suicide in first 2 weeks

MAOI 2 drugs 2 side effects

Phenelzine (Nardil),

Tranlycypromine (Parnate).

Side Effects: Dietary restriction, hypertensive crisis with other antidepressants. Rarely used.

SNRI 2 drugs 4 side effects

Venlafaxine (Effexor),

Duloxetine (Cymbalta)

Side Effects: HA, diaphoresis, insomnia, dry mouth

SNDI 1 drug with a note, 3 side effects

Mirtazapine (Remeron) can be used for chronic pain.

Side Effects: Drowsy, weight gain, HA

TCA 3 drugs 4 side effects

Amitriptyline (Elavil),

Impirpramine (Tofranil),

Nortiptyline (Pamelor)

Side Effects: Decreased BP, blurred vision, constipation, cardiac toxicity.

SARI 1 drug, 1 off label use ? but can cause ?

Trazadeon (Desyrel).

Side Effects: Off label use for sleep aid can cause vivid dreams

Ketamine given what form and with blank, treats what

IV/Intranasally with psychotherapy.

For treatment of resistant depression improvement seen within hours instead of days or weeks. Multiple treatments are required.

Distractibility a symptom of ? and a ? behavior that increases risk for ?

A mania S/S, a manic behavior that increases risk for unintended injury.

Dysthymic Disorder another name for it and def

Persistent Depressive Disorder (PDD)

Chronic mood disorder with same cognitive and physical problems as depression but with longer lasting symptoms.

ECT treats blank with blank, MOA, 2 side effects

Treatment for depression with psychosis. Electroconvulsive therapy is the induction of generalized grand mal seizures through the application of electrical current to the brain. (Most common on elderly)

-Treatment

   -Give short acting barbiturate and muscle paralyzing agent

   -Electric shock for 1 second

   -Cause seizure activity for 20-60 seconds

   -2-3 treatments per week for a total of 6-12 treatments

   -ECT 1x week to 1x per month for maintenance

-Side Effects:

   -Memory loss for a short period of time but may be permanent.

   -Patient may be confused for short periods of time

Flight of ideas Def

Racing, often unconnected, thoughts

Mania S/S

Grandiosity Def and symptom of ?

Inflated self esteem

Mania S/S

Hypersomnia Def

A physical symptom of major depressive disorder

Excessive daytime sleepiness and prolonged night time sleep

Insomnia Def and symptom of ?

A physical symptom of major depressive disorder.

Difficulty falling, staying, or falling back to sleep.

Impulsivity is a behavior factor that increases risk of ?

A behavioral factor that increases risk of suicide.

Lithium treats 1 thing, side effects 4, S/S of toxicity 7, patient teaching 4

Treatment for bipolar disorder

-Side Effects: Weight gain, hand tremors, mild nausea, general discomfort

-S/S of Lithium Toxicity: Tachycardia, hypotension, kidney failure, mental confusion/slurred speech, ECG changes, seizures, coma. (Monitor lab levels between 0.6-1.2 mEq/L)

-Patient Teaching:

   -Drink plenty of water (Lithium can cause polyuria), Dehydration can cause lithium toxicity, Lithium increases thirst

   -Expect GI upset

   -Thyroid function should be monitored every 6-12 months

   -Do not discontinue med abruptly

Major Depression S/S (physical 5)

-Mood: Depressed, anhedonia, feel worthless, hopeless guilt or despair

-Cognitive: Rumination, thoughts of suicide, poor concentration, poor memory, poor judgement, poor insight, Impaired problem solving, inability to cope with daily life

-Behavior: Anger and irritability

-Physical: Change in bowel habits, psychomotor retardation, psychomotor agitation, poor grooming, change in a sleep pattern. (Insomnia or hypersomnia)

Mania/hypomania s/s (8)

-Distractibility

-Indiscretion

-Grandiosity

-Flight of ideas

-Activity increased

-Sleep deficit without energy decrease

-Pressured speech

-Mood is excessively cheerful or may be irritable if told no or has to follow rules

Mood stabilizer drugs Def and 4 drugs

Anticonvulsants used adjunct to mood stabilizing dugs

-Valproate (Depakote, Depakene)

-Carbamazepine (Tegretol)

-Lamotrigine (Lamictal)-Serious side effect rash

-Oxcarbazepine (Trileptal)-Used off label for acute mania

Non-suicidal Self-injury Def

Self mutilation behaviors such as cutting, burning, scraping skin, hitting, and biting oneself and are inflicted to cause bleeding, bruising, or pain.

Premenstrual Dysphoric Disorder Def

Severe form of PMS occurs during pre-menstruation and is resolved by  menstruation

Pressured speech Def

Talkativeness without taking pauses

Psychomotor agitation Def

Pacing, hand wringing

Rapid Cycling Def and associated with?

Pattern of frequent mood shift, specifically 4+ depression or mania in 12 months. 

Hypothyroidism is associated with rapid cycling.

Rumination Def and symptom of ?

Repeatedly and persistently focusing on negative thoughts, feelings, or experiences.

Symptom of Major depressive disorder

Suicide, risks for self-harm 4

Psychiatric disorders-depression, bipolar-disorder, schizophrenia, PTSD, Borderline personality

Chronic medical conditions- Cancer, HIV/AIDS, diabetes, stroke, spinal cord injury

Environmental conditions--social isolation, victimization such as bullying/cyberbullying (especially adolescents), unemployment, critical life events, family history of depression/suicide

Behavioral factors-Behavioral factors that increase risk include impulsivity, erratic or unexplained changes from usual behavior, and unstable lifestyle

Seasonal Affective Disorder (SAD) Def, s/s 3, 1 treatment

Depression during specific seasons usually occurs during fall and winter.

-S/S: Low energy, hypersomnia, overt weight gain

-Treatment: Light therapy