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Psych PA EOR_Medications
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Psych PA EOR/MedicationsWhat is the DSM-V criteria of Major Depressive Disorder? - CORRECT
ANSWER-Depressed mood + anhedonia and >= 5 associated symptoms almost
every day for most of the days x 2 wks:
- fatigue
- insomnia or hypersomnia
- guilt or worthlessness
- thoughts of death or SI
- psychomotor agitation
- weight change >5%
- Decreased concentr./indecisiveness
What is the general pathophysiology of major depressive disorder? - CORRECT
ANSWER-Alteration in the neurotransmitters: serotonin, epinephrine,
norepinephrine, dopamine, acetylcholine, histamine
Neuroendocrine dysregulation: adrenal, thyroid or growth hormone disorders.
What is the management of MDD? - CORRECT ANSWER-1. Psychotherapy: 1st
line in mild to moderate
2. medications: SSRIs 1st line. SNRI, TCAs
3. Cognitive behavioral therapy
4. ECT.
What is the diagnostic criteria for Bipolar Disorder I? - CORRECT ANSWER->= 1
Manic episode and occasional Major Depressive episodes
What is the management of Bipolar Disorder Type I? - CORRECT ANSWER-1.
Mood stabilizers. 2nd or 1st gen antipsychotics. May add SSRI for depressive sx.
2. Good sleep Hygiene
,3. CBT
What is the diagnostic criteria of Bipolar Disorder Type 2? - CORRECT
ANSWER-Hypomania + Major depressive episode
What is the management of Bipolar Disorder Type 2? - CORRECT ANSWER-1.
Mania: Lithium, valproate, carbamazepine, Atypical antipsychotics
2. Depression: same as mania
3. Mixed: atypical antipsychotics, valproate
what is the diagnostic criteria of dysthymic disorder? - CORRECT ANSWER-mild
chronic form of major depression: chronically Depressed mood >2yr in adults
(>1yr in children)
Severity of mood does not meet criteria or major depression
What is the management of Dysthymic Disorder? - CORRECT ANSWER-Same
as MDD:
1. Psychotherapy 1st line
2. meds: SSRI, then SNRI, TCA
3. CBT
What is the dx criteria of GAD? - CORRECT ANSWER-excessive anxiety or
worry a majority of days in a 6-month period associated with >=3:
- fatigue
- restlessness
- difficulty concentrating
- muscle tension
- sleep disturbance
- irritability
, - shakiness
- HA
What is the Management of GAD? - CORRECT ANSWER-1. Antidepressants:
SSRIs
2. Bispirone (Buspar)
3. Benzodiazepines - short term only. BBlockers
4. Psychotherapy
What is the diagnostic criteria for Panic Disorder? - CORRECT ANSWER-1.
symptoms not due to substance, medical condition, or other mental disorder
2. recurrent, unexpected panic attacks 2+ not related to a trigger.
3. Panic attack followed by concern about more attacks.
What is the management of Panic Disorder? - CORRECT ANSWER-1. SSRIs
first line long-term tx
2. Benzodiazepines: for acute attacks, TCAs
3. CBT
What is the criteria for PTSD? - CORRECT ANSWER-1. Exposed to traumatic
event and actual or threatened death or serious injury/violation to self or others
AND 2. response may involve helplessness, dissociative sx, avoidance of
associated stimuli, emotional numbing, increased autonomic aurousal
What is the management of PTSD? - CORRECT ANSWER-1. Antidepressents:
SSRI first line
2. CBT: psychotherapy (individual or group tx), counseling
What is the drug class and brand name of Citalopram? - CORRECT
ANSWER-Celexa
SSRI
Note: Citalopram should not be used in pts with hypokalemia, hypomagnesemia,
recent MI or Heart Failure
What is the drug class and brand name of Escitalopram? - CORRECT
ANSWER-Lexapro SSRI
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