NU643 Week 13 Quiz Preparation

Description for use: This is an additional study tool, a blueprint, for the upcoming quiz 13. Don't forget that there is also a study guide posted under the learning activities.

1. Review the use of atypical antipsychotic use in pregnancy related to major congenital malformations: neural tube in the early weeks like 0-4, then the congenital heart defects 5-9, then the cleft pallet 9-14?
2. Review body fat distribution in boys vs girls and half-life considerations: may see a different in effect if drug is highly lipophilic, girls have a higher body fat content.
3. Review side effects of the cholinesterase inhibitors: GI, muscle cramps, fatigue, weight loss so body fat may be reduced, exacerbation of mania, or hypomania.
4. Review the prescribing of antipsychotics use in dementia and its side effects: Black box warning, beers criteria. Cardiac arrest
5. Review which className of psychiatric drugs carry the highest risks of Major congenital malformations: valproate acid , followed by lithium, Lamictal, antipsychotics
6. Review current holistic treatment for PMDD: eliminate caffeine, regular exercise, cutting out sugar, getting enough sleep
7. Review Memantine mechanism of action: briefly or temporarily blocks the NMDA receptor. So you can still learn, but it slows the response. Stabilizes decline and can improve cognition but doesn’t really slow decline.
8. Review the use of treatment plans in pediatric psychiatry: really review with the family the treatment plan. Psychotherapy first always, but then move on to meds. Safety issue: adhd meds. Where is it being stored. Urine screens on patients that they are actually taking the medication
9. Review first line treatment of persistent aggression: SSRI plus psychotherapy. CBT therapy.
10. Review considerations about the use of psychotropic in pregnancy: none are FDA approved in pregnancy or lactation. All cross the placenta, all are seen in breastmilk.
11. Review the use of Escitalopram in children & adolescents: can be used for depression in ages 12 and up
12. Review best drug choices in the treatment of acute aggression: lorazepam, Haldol, benadryll. Might see Seroquel, risperdal (second generation antipsychotics). Benzos are not indicated for chronic or persistent aggression
13. Review FDA warning regarding treating children with antidepressants: black box warning: increases suicidal ideation in age less than 24 for the first few weeks. Go low and slow. Keep an eye on them, document.
14. Review pharmacokinetic changes in pregnancy and dosages during pregnancy: pregnant women may need increased dosage. Increased metabolism, blood volume, weight changes in enzyme systems the CYP gets faster so drugs are eliminated faster
15. Review the use of beta blockers as a good choice in treating aggression: reduces heart rate, blood pressure, the physical sensations in the body which can help decrease the aggression. Can take a few weeks (4-6 wks to work)
16. Review managing behavioral and psychological symptom management of dementia: teach caregivers behavior is not intentional, reduce change, keep a consistent schedule, reminiscent therapy. Habilitation therapy: tie shoes, set table, ADL as long as possible. Music therapy. Physical exercise, keep them tired so they can sleep at night. Pet therapy.