Substance Abuse
Name 3 s/s of CNS depressant withdrawal (alcohol, benzodiazepines, barbiturates)
and 1 treatment for withdrawal symptoms
nausea, vomiting, tachycardia, diaphoresis, abdominal cramping, insomnia, irritability, delirium, seizures, tremors
Seizure precautions, thiamine, antiepileptics for alcohol, Flumazenil IV for Benzodiazepines, Barbiturates, phenobarbital or long-acting benzodiazepine
Name 3 risk factors for mental illness.
mental illness in family, poor coping mechanisms, stressful life events, hormonal influence, poor support system
Which drugs are used to treat anxiety but prolonged use may result in dependency?
Benzodiazepines
This type of therapy is useful for pts with severe depression, bipolar depressive disorder, mania, or depression with psychotic symptoms, especially when resistant to other treatments, including medications such as TCAs and MAOIs
What is electroconvulsive therapy? (ECT)
involves delivery of electricity through electrodes attached to forehead and temporal areas sufficient to cause brief seizure, series of 6-12 treatments is usually carried out at a rate of 2-3 per week, may be repeated once monthly to reduce relapse for recurrent depression, preprocedure same as preparing pt for surgery, informed consent, NPO, baseline vitals, have pt void, remove jewelry, dentures, hair pins, contact lenses, continuous vitals throughout tx, airway management (airway or bitestick to prevent pt from biting tongue during procedure)
What causes a major PTSD trigger for Owen while he's dating Christina?
Christina's music, ceiling fan, hospital shooting, fire alarm
What is a ceiling fan?
Name 3 s/s of Opioid withdrawal and 1 treatment for opioid withdrawal.
(codeine, morphine, heroin, meperidine (demerol), hydromorphone (dilaudid), methadone, fentanyl, oxycodone)
dilated pupils, excessive sweating, restlessness, agitation, tremors, tachycardia, hypertension, abdominal cramps, muscle spasms,
methadone, clonidine to reduce severity of withdrawal, oxazepam (muscle spasms and insomnia), antiemetics
Characterized by periods of elation during which there is an abnormally and persistently elevated, expansive, or irritable mood for at least 1 week and also includes at least 3 of the following: inflated self-esteem, decreased need for sleep, more than usual talkativeness, racing thoughts, distractibility, increase in goal-directed activity, and excessive involvement in pleasurable activities (spending money, shopping, gambling, sexual promiscuity)
What is a manic episode?
Which drug is a serotonin and dopamine agonist that is used in short-term treatment of anxiety?
Buspirone
This therapy is effective for patients with seasonal affective disorder (SAD): depressed mood occurring during fall and winter months when there are fewer days of sunlight (direct correlation of light with melatonin production)
(30 minutes of exposure to sunlight every day or more, maintenance is 30 minutes a day, antidepressant effect seen in 2-4 days)
Where does DeLuca stay when the other interns refuse to live with him?
The on-call room, Meredith's, Arizona's, his own place
What is Arizona's place?
Name 3 s/s of CNS stimulant withdrawal and 1 treatment for withdrawal
cocaine, amphetamines, crack
extreme fatigue, lethargy, disorientation, depression, drug craving, agitation, insomnia
primarily supportive, antidepressants
Identify 4 of these phobias:
agoraphobia, acrophobia, claustrophobia, hematophobia, hydrophobia, pyrophobia, xenophobia, zoophobia
agoraphobia (fear of public places), acrophobia (fear of heights), claustrophobia (enclosed spaces), hematophobia (blood), hydrophobia (water), pyrophobia (fire), xenophobia (strangers), zoophobia (animals)
What is the recommended treatment for panic disorder?
benzodiazepines and antidepressants
Name two positive schizophrenia symptoms.
Positive symptoms are presence of behaviors not normally seen, delusions (false beliefs), hallucinations that may involve any 5 senses (auditory, visual, tactile, gustatory, olfactory), disorganized speech patterns, disorganized or bizarre behavior
Adele's death coincides with what major event?
Valentine's Day, Miranda's wedding, Christmas Eve, Callie's wedding
What is Miranda's wedding?
Ingestion of alcohol when taking this substance leads to flushing, weakness, nausea/vomiting, dizziness, tachycardia, and hypotension, used as detoxification for alcohol abuse
Disulfiram (Antabuse)
This disorder is characterized by diminished interest or pleasure in almost all activities for most activities nearly every day
Major depression
Which drugs are most effective in the treatment of obsessive compulsive disorder?
SSRIs
Name two negative schizophrenia symptoms.
Negative symptoms: loss or absence of healthy behaviors that develop over time and hinder pt's ability to complete life tasks, flat affect, apathy, anhedonia, avolition (inability to pursue goal-directed behavior), alogia (poverty of speech), ambilvalence (inability to make a decision), minimal self-care, ineffective social skills, social withdrawal
Who originally auditioned to play Miranda Bailey?
Katherine Heigl, Ellen Pompeo, Sandra Oh, Sarah Ramirez
Who is Sandra Oh?
Name the antidotes for opioids and benzodiazepines
Romazicon (flumazenil), and naloxone (Narcan)
Describe food options for a patient experiencing a manic episode.
finger foods, small, frequent feedings and high-calorie, protein-rich snacks and fluids, easy-to-carry drinks that are high in vitamins, minerals, and electrolytes, avoid stimulants/caffeine
Which drugs seem to have some effect in treating PTSD?
SSRIs, especially sertraline (Zoloft)
How do you converse with a schizophrenic patient who is having hallucinations?
Acknowledge the pt's belief about delusion or hallucination experience but do not share in it; do not argue with the patient; instead encourage expression of feelings associated with delusion or hallucination
What state is April Kepner originally from?
Idaho, Oklahoma, Ohio, Iowa
What is Ohio?