Term
| Medical conditions assoc with Depression |
|
Definition
1) Hypothyroidism (dx: TSH, rx: triiodothyronine
(T3) and/or thyroxine (T4)0
2) Parkinson's Disease |
|
|
Term
| How do differentiate between dementia and Depression? |
|
Definition
Mini Mental state exam
or
Mnicog:
1) repeat 3 words
2)Draw a clock @ 10.45
3) repeat 3 words |
|
|
Term
|
Definition
SIGECAPS
Sleep
Interest (loss of)
guilt
energy (decreased)
concentration (decreased)
Appetite (inc or dec)
psychomotor retardation
suicidal ideation (+/- plan) |
|
|
Term
| Major Depressive Disorder vs Bereavement |
|
Definition
Guilt about things other than actions taken or not taken at the time of the
death
Thoughts of death other than feeling that he or she would be better off dead
or should have died with the deceased person
Morbid preoccupation with worthlessness
Marked psychomotor retardation
Prolonged and marked functional impairment
Hallucinatory experiences other than hearing the voice of, or transiently
seeing the image of, the deceased person. |
|
|
Term
| (T/F) Hispanics have their depression identified less frequently non-Hispanic whites |
|
Definition
| True. Also hispanics present more with somatic complaints and less likely to receive treatment |
|
|
Term
| Increased Risk for suicide |
|
Definition
| White male, previous attempt |
|
|
Term
| Increased Risk of suicide in elderly |
|
Definition
widower, live alone, perceived poor health status, reduced sleep quality, no confidant, stressful life events.
Rates of completed suicide increases with age. Drug OD is most common means |
|
|
Term
|
Definition
| blocks reuptake of serotonin, post-synaptic effect |
|
|
Term
|
Definition
| Citalopram (celexa), fluoxetine (prozac), fluvocamine (luvox), paroxetine (paxil), sertaline (zoloft), escitalopram (lexapro) |
|
|
Term
| Venlafaxine (Effexor), Class |
|
Definition
|
|
Term
| bupropion (Wellbutrin), Class |
|
Definition
|
|
Term
| nefazodone (Serzone), trazodone (Desyrel), Class |
|
Definition
| Serotonin antagonist and reuptake inhibitors |
|
|
Term
| Mirtazapine (Remeron), Class |
|
Definition
| Norepinephrine and serotonin antagonist, antihistamine effects |
|
|
Term
| duloxatine (Cymbalta), Class |
|
Definition
| Serotonin and norepinephrine reuptake inhibitor |
|
|
Term
| Tricyclic Antidepresseant mechanism |
|
Definition
| blocks reuptake of NE and serotonin, postsynaptic effect |
|
|
Term
|
Definition
| nortrpityline (Pamelor), amitriptyline, clomipramine (anafranil), doxepin (Sinequan) |
|
|
Term
|
Definition
| (rarely used today). blocks presynaptic catabolism of NE and Serotonin |
|
|
Term
|
Definition
| phenelzine (Nardil), tranylcypromine (parnate) |
|
|
Term
|
Definition
| headaches, sleep disturbances, GI problems (nausea and diarrhea), SIADH, serotonin syndrome, inc risk of GI bleeding, inc risk of falls (elderly) |
|
|
Term
|
Definition
|
|
Term
| Common causes of insomnia in elderly |
|
Definition
Depression/anxiety
Environmental problems
Drugs/alcohol/caffeine
Sleep apnea
Parasomnias (RLS, periodic leg movt, REM behavior disorder)
Sleep cycle disturbances
CV/resp disorders (asthma, COPD, CHF)
Pain, pruritus
GERD
Hyperthyroidism |
|
|
Term
| Common causes of insomnia in elderly |
|
Definition
Depression/anxiety
Environmental problems
Drugs/alcohol/caffeine
Sleep apnea
Parasomnias (RLS, periodic leg movt, REM behavior disorder)
Sleep cycle disturbances
CV/resp disorders (asthma, COPD, CHF)
Pain, pruritus
GERD
Hyperthyroidism |
|
|
Term
|
Definition
Dementia
Shared living situation
Caregiver substance abuse or mental illness
Heavy dependence of caregiver on elder
social isolation of elder |
|
|
Term
|
Definition
| USPSTF: All adults, esp those with chronic disease |
|
|
Term
| Studies to order for Fatigue |
|
Definition
| CBC, TSH, ECG, Metabolic Panel (electrolyte, renal, hepatic), ESR (for rheum disease) |
|
|
Term
|
Definition
First line pharm: SSRI (contraindicated in preg)
-first episode: take for 9-12 months
-recurrent episode: rx for 2-3 years
-multiple recurrences: rx indefn
Psychotherapy (CBT, interpersonal therapy)
Exercise
avoid drugs and alcohol
St Johns wort is alternative |
|
|
Term
| How do you evaluate Suicide |
|
Definition
SAD PERSONS
-Sex (male)
-Age (<19 >45)
-Depression
-Previous attempts
-Ethanol
-Rational thinking impaired
-Social support lacking
-Organized plan
-No significant other
-Sickness |
|
|
Term
| Fluoxetine (Prozac) Side fx |
|
Definition
| Agitation, motor restlessness, dec libido, insomnia |
|
|
Term
| Sertaline (Zoloft) sidefx |
|
Definition
| More GI side fx than usual |
|
|
Term
| Paroxetine (Paxil) sidefx |
|
Definition
| Weight gain, impotence, sedation, constipation. Most likely to cause antidepressant discontinuation syndrome |
|
|
Term
|
Definition
| Greater frequency of emesis compared to other SSRIs |
|
|
Term
|
Definition
| Nausea, dry mouth, somnolence |
|
|
Term
|
Definition
| Less side fx that citalopram (nausea, dry mouth, somnolence) |
|
|
