pre test

SEC 3 below?

ANA - ethics

APNA-latest developments and practices

ISPN - evidence based practice, global advocacy. cult sensitive care, global best practices, research

CRSS? columbia suicide rating scale

modeling. contingency management.

borderline personality disorder, emotional disregulation - DBT. dialectic, balancing opposing ideas. validation/acceptance. mindfulness.

ACT acceptance and commitment therapy - chronic pain mentioned

EMDR - PTSD

Supportive - cope with stressors, life transitions, stabilization. problem solving in the moment. can happen during med mgmt appointments

humanistic, person centered therapy

gesalt - here and now. awareness. personal responsibility. cycles of experiences- helps the finish the process if halted. empty chair - talk to each other (themselves). body awareness. roleplaying and reversal technique.

existential - life meaning-focus

SFT - brief, solution focused. strengths, resources, goals, solutions not problems

IPT - communication and social functioning, good for DPN

st john + SSRI serotnonin syndrome

omg3 fatty acids - dpn, brain function

ppi can interfere w/ absorption of b12/folate?

90 percent of serotonin produced by gut

PTSD can lead to drug abuse to cope/alcohol, Therapy exposure, group, meds -SSRI, anx meds, sleep meds

GAD has issues self soothing. genetic + enviromental, runs in families, twice as prevalent females. tx: psychotherapy (CBT), medication (benzo, antidpn)

Phobias - extreme, unreasonable, irrational fear. more likely if fam has one, traumatic event. CBT to show reaction is irrational etc

Soc anxiety disorder also drug abuse to be able to go in public etc. can lead to derealization

SAD - pyscho therapy, SSRIs, bblockers, benzos

schizo has no racial bias. tx: antispychotics but tricky, effective but tx, cost, side effects (metabolic syndrome?)

bipolar 10x more likely if fam has disorder

tx - lithium salts (mood stabilizer). antidpn (can trigger manic episode). anti psychotics, anticonvulsants, benzos

talk CBT DONT treat the disorder but can be helpful after manic episode. prevention by helping with stressful situations that can lead to mania

Delirium - half of elderly members in hospital will have one episode. hypo and hyperactive delirium can be types. usually temporary if source resolved. dementia instead progressive. risk factors, recent sx, no sleeping, opiates. orient and comfortable is tx.halperidol 2nd gen antipyschotics possible med txs

Bulimia - binge and purge (1x/week for 3 months). anorexia is diff bc person acutally underweight. genetic and social components. pyschotherapy and CBT, meds SSRIs

ADD ADHD are same. ADHD newer and includes more. higher likelyhood if twin has it, some genetic component. meds aimed at adding neuro receptors. meth amphetamines but SLOW release to avoid euphoria/addiction

MDD. high genetic component. monoamine hypothesis, low bad, increase them and they feel better. activated by stress hypothesis if predisposed.

atypical dpn you eat and sleep MORE instead of less like in typical (melancholic) dpn

pharm tx: SSRIs bread and butter. also SNRIs, atypicals, MOAIs, TCAs,

TSH and free t4 labs

LFT and CMP

Infection CBC and anemia CBC

Taking a folate supplement can mask vitamin B12 deficiency

A1C if antipsychotics or metabolic risk are relevant, urine pregnancy as appropriate, urine drug screen if substance induced symptoms are possible.

carbamazepine and clozapine can cause agranulocytosis CBC (ANC?)

CK for muscle rigidity

CBC and chemistry, creatinine, LFTs, CK, tox screen, blood gas, and cultures ± CSF analysis

Varenicline can have SI side effects. contra in people w/ SI or psych history that can lead to SI maybe

PHQ-9 f/u score check in two weeks?

MI address the DISSONANCE between goals and current actions

Serotonin syndrome. no SSRI w/ SJW

herbs contra

CAM tx categories

supps

5-HYDROXYTRYPTOPHAN, L-TRYPTOPHAN. 5-hydroxytryptophan and L-tryptophan have been extensively investigated for their putative antidepressant and anxiolytic effects.

Magnesium deficiency is an established risk factor for overall poor mental health, depressed mood, and cognitive impairment. Preliminary evidence from randomized controlled studies supports the antidepressant efficacy of zinc supplementation used as an adjuvant to prescription antidepressants. selenium limited evidence

Two omega-3 fatty acids, EPA and DHA, have been extensively investigated as treatments of depressed mood, ADHD, schizophrenia, and other psychiatric disorders. trauma/PTSD after first incident. EPA stronger for dpn, DHA for cog. alzheimers evidence. anti-inflammation

Ashwagandha is an effective monotherapy of anxiety symptoms related to chronic stress and may be an effective adjunctive treatment of GAD

CBD may be an effective treatment of GAD, panic disorder, social anxiety disorder (SAD), OCD, and PTSD

Galphimia is used as a sedative and anxiolytic in traditional Mexican medicine

Ginkgo (Ginkgo biloba) extract is used in Europe and North America to treat dementia and other neurodegenerative diseases. neuroprotective effect

Ginseng/schizo - individuals taking the ginseng preparation reported significantly fewer neurologic adverse effects after 4 weeks than the placebo group. Further studies are needed to confirm these findings and determine the optimal dosing of ginseng as an adjuvant to antipsychotics.

Kava - treatment of “stress” and moderate anxiety in healthy adults

The essential oil of lavender has been widely used in traditional Persian medicine for millennia to treat medical disorders and mental health problems, including anxiety, insomnia, and depressed mood

R. rosea is used in traditional Russian medicine to enhance stamina, reduce fatigue, improve sleep, and enhance mood. R. rosea affect the HPA axis reducing serum cortisol levels reducing fatigue, and decreasing stress-related anxiety

RCTs support that DHEA supplementation of 90 to 450 mg/day reduces the severity of depressed mood, antipsychotic effects?

SJW is widely used to treat depressed mood. SSRI, serotonin syndrome

Saffron, obtained from the stigmas of the flower of Crocus sativa, is widely used as a spice and medicinal agent in traditional Persian medicine. Antidepressant effects may involve anti-inflammatory and immunomodulatory effects and reuptake inhibition of serotonin, norepinephrine, and dopamine

TOOTHED CLUBMOSS (HUPERZIA SERRATA). Huperzine A, an alkaloid derivative of the herb Huperzia serrata is a central ingredient of many compound herbal formulas used in Chinese medicine to treat cognitive impairment related to normal aging

TURMERIC (CURCUMA LONGA). Curcumin is the principal bioactive constituent of Turmeric. Animal studies have established that curcumin has strong antioxidant and anti-inflammatory activity, suggesting that it may have beneficial effects on a range of medical and neuropsychiatric disorders associated with chronic inflammation. The findings of animal studies suggest that antidepressant effects of curcumin may be related to the modulatory activity of the monoamine neurotransmitters serotonin, norepinephrine, and dopamine

VALERIAN (VALERIANA OFFICINALIS). sleep/insom

Psychedelics including D-lysergic acid diethylamide (LSD), ketamine, psilocybin, and ayahuasca are extensively investigated as potential treatments of depressed mood, anxiety disorders, PTSD, and other psychiatric disorders