LMR - Georgette's
What drugs should be avoided with Kava Kava? ANS: Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH? ANS: 0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism ANS: Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? ANS: Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? ANS: Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? ANS: Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? ANS: Depression
,Hyperthyroidism mimics symptoms of what psychiatric disorder? ANS: Mania
Valproic acid produces what teratogenic effect? ANS: Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? ANS: Liver (hepatoxicity)
What are 4 signs of hepatoxicity? ANS: Abdominal pain in the URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
What is the therapeutic range for valproic acid? ANS: 50-125 mcg/ml
What is a toxic level of valproic acid? ANS: >150 mcg/ml
What are 4 signs of valproic acid toxicity? ANS: Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
A pt on Depakote C/O Abdominal pain in the URQ and Reddish-brown urine. What do you suspect?
What do you do? ANS: Hepatotoxicity; hold med, draw LFT's (priority), DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? ANS: D/C drug
Check drug level
,Obtain LFTs
Obtain ammonia level
A pregnant pt is taking accutane, zyprexa and abilify; what med needs to be d/c'd? ANS: Accutane (used
for acne; Causes birth Defects!!!)
What herbal supplement is used for anxiety, stress, and insomnia? What is the major side effect with
Kava Kava? ANS: Kava Kava
liver damage
What are 5 symptoms of Stephen's Johnson Syndrome? ANS: Fever -Key sx to suspect SJS; high yield (HY)
burning of mouth/eyes -HY
Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least weight gain? ANS: Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? ANS: Lurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? ANS: Aripiprazole (Abilify)
Your pt is taking Kava and you need to add an AS to manage their SCZ, which do you add? ANS:
Aripiprazole (least sedating)
, What are 2 hallmark symptoms of delirium? ANS: Acute onset
disturbance of LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? ANS: Low dose Haldol (QTc check first)
16 y/o C/O feeling funny after inhaling Acetone (nail polish remover). What is your action? ANS: Do UDS;
chances are they may be abusing other substances
What 4 drugs can cause mania? ANS: "SAID"
Steroids
Antidepressants (in BPD)
Isoniazid (INH)
Disulfiram (Antabuse)
What 6 drugs can induce depression? ANS: "SIP BARB"
Steroids
Interferon,
Progesterone
Beta blockers
Accutane, (Isotretinoin)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
What drugs should be avoided with Kava Kava? ANS: Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH? ANS: 0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism ANS: Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? ANS: Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? ANS: Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? ANS: Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? ANS: Depression
,Hyperthyroidism mimics symptoms of what psychiatric disorder? ANS: Mania
Valproic acid produces what teratogenic effect? ANS: Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? ANS: Liver (hepatoxicity)
What are 4 signs of hepatoxicity? ANS: Abdominal pain in the URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
What is the therapeutic range for valproic acid? ANS: 50-125 mcg/ml
What is a toxic level of valproic acid? ANS: >150 mcg/ml
What are 4 signs of valproic acid toxicity? ANS: Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
A pt on Depakote C/O Abdominal pain in the URQ and Reddish-brown urine. What do you suspect?
What do you do? ANS: Hepatotoxicity; hold med, draw LFT's (priority), DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? ANS: D/C drug
Check drug level
,Obtain LFTs
Obtain ammonia level
A pregnant pt is taking accutane, zyprexa and abilify; what med needs to be d/c'd? ANS: Accutane (used
for acne; Causes birth Defects!!!)
What herbal supplement is used for anxiety, stress, and insomnia? What is the major side effect with
Kava Kava? ANS: Kava Kava
liver damage
What are 5 symptoms of Stephen's Johnson Syndrome? ANS: Fever -Key sx to suspect SJS; high yield (HY)
burning of mouth/eyes -HY
Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least weight gain? ANS: Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? ANS: Lurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? ANS: Aripiprazole (Abilify)
Your pt is taking Kava and you need to add an AS to manage their SCZ, which do you add? ANS:
Aripiprazole (least sedating)
, What are 2 hallmark symptoms of delirium? ANS: Acute onset
disturbance of LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? ANS: Low dose Haldol (QTc check first)
16 y/o C/O feeling funny after inhaling Acetone (nail polish remover). What is your action? ANS: Do UDS;
chances are they may be abusing other substances
What 4 drugs can cause mania? ANS: "SAID"
Steroids
Antidepressants (in BPD)
Isoniazid (INH)
Disulfiram (Antabuse)
What 6 drugs can induce depression? ANS: "SIP BARB"
Steroids
Interferon,
Progesterone
Beta blockers
Accutane, (Isotretinoin)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
