Medicine > QUESTIONS & ANSWERS > MH701 - Exam 1 - Big Set. 71 pages of questions with Accurate answers. 99% Examinable. (All)

MH701 - Exam 1 - Big Set. 71 pages of questions with Accurate answers. 99% Examinable.

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MH701 - Exam 1 - Big Set. 71 pages of questions with Accurate answers. 99% Examinable. These drugs are most likely to cause this discontinuation syndrome - Ans-1-Paxil 2-Effexor Goal of antidepre... ssant therapy: - Ans-Symptom remission and return to baseline functioning Initial therapy with antidepressants - Ans-severe: combo of meds and therapy mild-mod: options: meds alone therapy alone combo What would you recommend to patients who request a CAM therapies? - Ans--St. John's Wart (SAMe) -light therapy -exercise Factors favoring treatment with an antidepressant: - Ans--Agitation -Problems with sleep and/or appetite -hx of response to antidepressant -patient preference -moderate to severe symptoms. With antidepressant therapy, response can be expected in: - Ans-50-75% of pts Choice of Antidepressant - Ans--response history (if not initial episode) -Comorbidities -Depressive symptoms-Safety/tolerability -Drug interactions -Pharmacokinetics -Cost -Patient preference What are the most bothersome symptoms? - Ans-Anxious, Energized, Vegetative, Altered Sleep, Altered Sex Drive, Appetite Change, Fatigue, Hypersomnia SSRIs from most energizing to most sedating: - Ans-1-Fluoxetine (Prozac) 2-Sertraline (Zoloft) 3-Citalopram (Celexa) 4-Escitalopram (Lexapro) 5-Paroxetine (Paxil) When treating depression w/ anxiety: - Ans--less energizing SSRI, Venlafaxine or Duloxetine -Viibryd if others fail -if fluoxetine w/ anxiety be sure to start low and titrate slowly to avoid activation of anxiety -Avoid Wellbutrin too activating; increased anxiety most common clinical mistake leading to an unsuccessful trial of an antidepressant drug is: - Ans-too low a dosage for too short a time If the pt is having sexual side effects but you do not want to change the antidepressant, what can you add on? - Ans-bupropion (welbutrin) buspirone (buspar) phosphodiesterase inhibitor (eg: viagra) Sildenafil (Viagra) - Ans-does reduce SSRI-induced sexual dysfunction in men Tadalafil (Cialis) - Ans-may reduce SSRI-induced sexual dysfunction in menPhosphodiesterase Inhibitors - Ans-milrinone (Primacor) most n/v - Ans-prozac, effexor, cymbalta most diarrhea - Ans-zoloft akathisia - Ans-inner restlessness Insomnia may be reduced through - Ans-a.m. dosing, good sleep hygiene, CBT, melatonin or adding trazodone, a serotonin reuptake inhibitor/antagonist most common SSRI to cause weight gain is - Ans-paroxetine (Paxil) weight neutral/loss - Ans-Bupropion (Wellbutrin) and fluoxetine (Prozac) may cause weight loss - Ans-Venlafaxine (Effexor) least likely to cause discontinuation syndrome - Ans-prozac TCAs can cause - Ans-anticholinergic symptoms -mental status changes -urinary retention -blurred vision. TCA has the least anticholinergic side effects - Ans-Desipramine TCA having the greatest anticholinergic side effects - Ans-amitriptyline Citalopram (Celexa) is associated with - Ans-QT interval prolongation and torsade de pointe --FDA recommends against using doses > 40 mg/day MAOs when combined with SSRIs, SNRIs and TCAs can cause - Ans-a hypertensive crisismay cause dose-dependent HTN - Ans-Buproprion (Wellbutrin), venlafaxine (Effexor), duloxetine and desvenlafaxine (Pristiq) [Show More]

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