Georgettes LMR Complete Study Set
g g g g
Whengquestionsgaskgforgagprioritygaction...thinkgabout...
ABC,gairwaygbreathing,gcirculationg
Maslowsghierarchy
Ifgundecidedgonganganswergduegtoghighgsimilarities,gchoose:
thegumbrellaganswer
Whatgisgthegmostgcommongsidegeffectgofgolanzapine/zyprexa
metabolicgsyndrome
whatgisgthegdifferencegbetweengtypicalgandgatypicalgantipsychotics
Atypicalg5HT2Agspecific
1stgpsychoticgbreak...gtwogactionsgtogtake
UDSgandgr/ogsub
ConsidergIMgGeodongorgInvegagThr
eegAPgwithgleastgweightggain
Latuda,gAbilify,gGeodon
Alwaysgencourageginterprofessionalgcollaborationgbetwe
engtherapists/pcps/SW/RN,gthegENTIREgteam
TSHgHigh,gthen. ..t3/t4
T3,gT4glow
TSHglow,gthen...t3/t4
T3,gT4ghigh
cold/hotgsensitivitygwithgt3/t4grelationship
T3/T4glow,ghypothyroid,gcold,gslow
T3/T4ghigh,ghyperthyroid,ghot,gflushed,gtachyg
Whatgbirthgdefectgcangbegcausedgbygdepakote
?
,Spinagbifida
Whatgorgangdoesgdepakotegcausegtoxicity?gandgwhatgsxgwouldgyougexpectgtogsee?glabsgtogrun?
Hepatotoxicity:gRUQgpain,greddishgbrowngurine-
DogLFTs
kavagkavagisgusedgtogtreat
anxietygandginsomnia
Rashgandgfevergassociatedgwithgtegretol,gsuspect
...
WhatgallelegisgHLABg1502gassociated?
Asians.gTheygCANNOTghavegtegretol.gTestgallgasiansgforgthisgallele.g
whatgraregandgdangerousgsidegeffectsgaregassociatedgwithgtegretol
Aplasticganemia
Agranulocytosis-
DCgatgANCglessgthang1000gSx'sgofgagranul
ocytosis
unusualgbleedinggorgbruising,gmouthgsores,ginfections,gfever,gsoregthroat,gfatigu
egifgstartinggagwomangonglithiumgwhatgtestgshouldgbegdone?gwhy?
HCG--
riskgofgebsteinganomalygadversegs/
egofglamictal/lamotrigine
SJS
labsgtogcheckegBEFOREgstartinggonglithium
BUN
gCRE
urinegprotein
Whatgdoesgproteingingurinegindicate
kidneygimpairment;g4+gproteingingurine=yougcannotgstartgonglithiu
mgbestgchoicegmedgforgdecreasinggsigingbipolargdisorder.
lithium
,bestgchoicegmedgforgsigingschizophrenia
clozaril
bestgchoicegmedgforgSIgingborderline
lithium
WhatgmedicationsgwillgINCREASEgLiglevels
NSAIDS
gACE's
Thiazides/HCTZ
Besidesgmedications,gwhatgelsegcangcausegincreasedgLiglevels
dehydrationghypon
atremia
lithiumgs/egincgN/V,gwhichgwillgeffectgelectrolytes,gandgdehydrationgstatu
sgwhatgtypegofgtremorsgwillgyougseegwithglithiumgtoxicity?
coursegtremors
lithiumgcangcausegwhatgothergcomorbidities?
hypothyroidismgma
culopapulargrashgle
ukocytosis
twaveginversion
whatgisgagdefininggcharacteristicgofgNMSgvsgSS
musclegrigidity
Sx's/labsgassociatedgwithgNMS
IncgCPK,gWBC,gLFT
Rhabdomyolosisgmy
oglobinuria
Cangleadgtogmutism
myoglobinuria/rhabdogcangcausegcherrygcoloredgurinegTr
eatmentgforgNMSgandgwhatgeachgdoes
DCgthegoffendinggagent
gbromocriptin-
D2gagonis
, dantrolene:gmusclegrelaxant
Makegsuregifg?gisgaskinggforgagonistgorgrelaxan
tgSxgofgSS
HYPERREFLEXIA
myoclonicgjerksgtre
atmentgforgSS
ciproheptadine
howgtogbestgPREVENTgSS
followgpropergtransitiongprotocols
SSRIgtogMAOI=14gdays
ProzacgtogMAOI=5-6gweeks
Triptansg(Imitrexgsumatriptan)gcangalsogcausegSSgduegtogserotoningincreasegwithgtheguse
giveganygNDRIgwelbutrin
WhygaregSSRIsgconsideredgthegsafestgforgusegingdepression
safestgforgODgfirstglinegtreatmentgforgdepressiongantidepr
essantgforgcancer
citalopramgandgescitalopramlessgdruggtogdrugginteractionsgdepress
edgpatientgpresentsgwithgfatiguegandglowgenergy,gconsider:
NDRIgwellbutrin
sexualgs/egwithgssri?gtry...
wellbutringduegtoglowergriskgofgsexualgs/e
Whatgmedicationgmustgbegavoidedgifgclientghasgseizureghistorygorgeatinggdisorder?gwhy?
wellbutringduegtogdecreasinggthegseizuregthreshold
gifgclientghasgdepressiongandgneuropathicgpain
SNRIgorgTCAgforgtreatmentgofgBOTH
Whatgmedgclassgtreatsgneuropathicgpaingwell
g g g g
Whengquestionsgaskgforgagprioritygaction...thinkgabout...
ABC,gairwaygbreathing,gcirculationg
Maslowsghierarchy
Ifgundecidedgonganganswergduegtoghighgsimilarities,gchoose:
thegumbrellaganswer
Whatgisgthegmostgcommongsidegeffectgofgolanzapine/zyprexa
metabolicgsyndrome
whatgisgthegdifferencegbetweengtypicalgandgatypicalgantipsychotics
Atypicalg5HT2Agspecific
1stgpsychoticgbreak...gtwogactionsgtogtake
UDSgandgr/ogsub
ConsidergIMgGeodongorgInvegagThr
eegAPgwithgleastgweightggain
Latuda,gAbilify,gGeodon
Alwaysgencourageginterprofessionalgcollaborationgbetwe
engtherapists/pcps/SW/RN,gthegENTIREgteam
TSHgHigh,gthen. ..t3/t4
T3,gT4glow
TSHglow,gthen...t3/t4
T3,gT4ghigh
cold/hotgsensitivitygwithgt3/t4grelationship
T3/T4glow,ghypothyroid,gcold,gslow
T3/T4ghigh,ghyperthyroid,ghot,gflushed,gtachyg
Whatgbirthgdefectgcangbegcausedgbygdepakote
?
,Spinagbifida
Whatgorgangdoesgdepakotegcausegtoxicity?gandgwhatgsxgwouldgyougexpectgtogsee?glabsgtogrun?
Hepatotoxicity:gRUQgpain,greddishgbrowngurine-
DogLFTs
kavagkavagisgusedgtogtreat
anxietygandginsomnia
Rashgandgfevergassociatedgwithgtegretol,gsuspect
...
WhatgallelegisgHLABg1502gassociated?
Asians.gTheygCANNOTghavegtegretol.gTestgallgasiansgforgthisgallele.g
whatgraregandgdangerousgsidegeffectsgaregassociatedgwithgtegretol
Aplasticganemia
Agranulocytosis-
DCgatgANCglessgthang1000gSx'sgofgagranul
ocytosis
unusualgbleedinggorgbruising,gmouthgsores,ginfections,gfever,gsoregthroat,gfatigu
egifgstartinggagwomangonglithiumgwhatgtestgshouldgbegdone?gwhy?
HCG--
riskgofgebsteinganomalygadversegs/
egofglamictal/lamotrigine
SJS
labsgtogcheckegBEFOREgstartinggonglithium
BUN
gCRE
urinegprotein
Whatgdoesgproteingingurinegindicate
kidneygimpairment;g4+gproteingingurine=yougcannotgstartgonglithiu
mgbestgchoicegmedgforgdecreasinggsigingbipolargdisorder.
lithium
,bestgchoicegmedgforgsigingschizophrenia
clozaril
bestgchoicegmedgforgSIgingborderline
lithium
WhatgmedicationsgwillgINCREASEgLiglevels
NSAIDS
gACE's
Thiazides/HCTZ
Besidesgmedications,gwhatgelsegcangcausegincreasedgLiglevels
dehydrationghypon
atremia
lithiumgs/egincgN/V,gwhichgwillgeffectgelectrolytes,gandgdehydrationgstatu
sgwhatgtypegofgtremorsgwillgyougseegwithglithiumgtoxicity?
coursegtremors
lithiumgcangcausegwhatgothergcomorbidities?
hypothyroidismgma
culopapulargrashgle
ukocytosis
twaveginversion
whatgisgagdefininggcharacteristicgofgNMSgvsgSS
musclegrigidity
Sx's/labsgassociatedgwithgNMS
IncgCPK,gWBC,gLFT
Rhabdomyolosisgmy
oglobinuria
Cangleadgtogmutism
myoglobinuria/rhabdogcangcausegcherrygcoloredgurinegTr
eatmentgforgNMSgandgwhatgeachgdoes
DCgthegoffendinggagent
gbromocriptin-
D2gagonis
, dantrolene:gmusclegrelaxant
Makegsuregifg?gisgaskinggforgagonistgorgrelaxan
tgSxgofgSS
HYPERREFLEXIA
myoclonicgjerksgtre
atmentgforgSS
ciproheptadine
howgtogbestgPREVENTgSS
followgpropergtransitiongprotocols
SSRIgtogMAOI=14gdays
ProzacgtogMAOI=5-6gweeks
Triptansg(Imitrexgsumatriptan)gcangalsogcausegSSgduegtogserotoningincreasegwithgtheguse
giveganygNDRIgwelbutrin
WhygaregSSRIsgconsideredgthegsafestgforgusegingdepression
safestgforgODgfirstglinegtreatmentgforgdepressiongantidepr
essantgforgcancer
citalopramgandgescitalopramlessgdruggtogdrugginteractionsgdepress
edgpatientgpresentsgwithgfatiguegandglowgenergy,gconsider:
NDRIgwellbutrin
sexualgs/egwithgssri?gtry...
wellbutringduegtoglowergriskgofgsexualgs/e
Whatgmedicationgmustgbegavoidedgifgclientghasgseizureghistorygorgeatinggdisorder?gwhy?
wellbutringduegtogdecreasinggthegseizuregthreshold
gifgclientghasgdepressiongandgneuropathicgpain
SNRIgorgTCAgforgtreatmentgofgBOTH
Whatgmedgclassgtreatsgneuropathicgpaingwell
