12982235
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Quiz von Melanie Grynsztejn, aktualisiert more than 1 year ago
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Erstellt von Melanie Grynsztejn
vor mehr als 6 Jahre
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Frage 1
Frage
Which diagnoses are most often associated with EDOs
Antworten
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Schizophrenia
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Anxiety disorders
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Obsessive compulsive disorders
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Substance use disorders
Frage 2
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Anorexia nervosa has a predominantly female disorder with a mean age of onset of 15 years old
Antworten
- True
- False
Frage 3
Frage
Patients with Anorexia Nervosa (AN) and a psychiatric comorbidity have [blank_start]higher[blank_end] mortality rates than those without
Antworten
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higher
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lower
Frage 4
Frage
Comorbid disorders for Anorexia Nervosa include
Antworten
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MDD
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Anxiety disorders (social phobia & GAD)
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OCD
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Substance use disorders
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Personality disorders
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Schizophrenia
Frage 5
Frage
With EDO, a detailed history to clarify timeline is critical because treating the core issue is essential for recovery. ADHD treatment, anxiety and depression may also cause weight loss. MDD may cause loss of appetite.
Antworten
- True
- False
Frage 6
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Anorexia nervosa has the highest death rate of any mental health illness
Antworten
- True
- False
Frage 7
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[blank_start]Food[blank_end] is your best medicine in aneroxia nervosa
Antworten
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Food
Frage 8
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What is the primary aim in the beginning stages of treatment of aneroxia nervosa?
Antworten
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Normalize and regulate eating patterns
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Treat with medications to help with mood, andanxiety
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Begin family-based interventions
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Individualized therapy interventions
Frage 9
Frage
Prior to medication initiation for anorexia nervosa, a prescriber needs to have
Antworten
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weight and height
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% IBW
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Orthostatic vitals
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EKG
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24 hour diet diary
Frage 10
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SSRIs are the gold standard treament for sever depression, anxiety/OCD [blank_start]after[blank_end] weight restoration
Antworten
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after
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during initial treatment before
Frage 11
Frage
Which SSRI should be avoided with anorexia nervosa due to QTc prolongation?
Antworten
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Fluoxetine
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Citalopram
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Fluvoxamine
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Paroxetine
Frage 12
Frage
SSRIs are FDA indicated for anorexia nervosa
Antworten
- True
- False
Frage 13
Frage
[blank_start]Fluoxetine[blank_end] and [blank_start]citalopram[blank_end] have some evidence for relapse prevention in weight-stored anorexics receiving treatment
Antworten
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Fluoxetine
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Setraline
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Paroxetine
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Fluvoxamine
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Setraline
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citalopram
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Fluvoxamine
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Paroxetine
Frage 14
Frage
MOA for SSRI
Antworten
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
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Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
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: Interacts with GABA receptors to enhance GABA effects
Frage 15
Frage
Which atypical antipsychotic has some evidence to help restore weight more quickly as adjunctive treatment to other interventions?
Antworten
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Risperidone
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Apiprazole
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Olanzapine
Frage 16
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MOA for atypical antipsychotic used in anorexia nervosa is
Antworten
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Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CN
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
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Blocks voltage-dependent sodium & calcium channels
Frage 17
Frage
Cigarettes [blank_start]decrease[blank_end] serum concentration of olanzapine
Antworten
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decrease
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increase
Frage 18
Frage
Olanzapine will interact with anything causing CNS depression including opioids, barbiturates, benzodiazepines, general anesthetics, and anticonvulsants such as pregabalin
Antworten
- True
- False
Frage 19
Frage
There is mixed evidence for the use of BZ to reduce meal anxiety. Typically only ___________ used off-label
Antworten
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Alprazolam
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Clonazepam
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Lorazepam
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Diazepam
Frage 20
Frage
BZ should be avoided with opioids
Antworten
- True
- False
Frage 21
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MOA for benzodiazepines is
Antworten
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Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
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Interaction with GABA receptors to enhance GABA effects
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
Frage 22
Frage
The epdimiology of Bulimia Nervosa is greater in females than males and onset is later than AN, either late adolescence or early adulthood at 19.4 years as compared to 15 years.
Antworten
- True
- False
Frage 23
Frage
Comormid illnesses for bulimia nervosa are similar to AN with
Antworten
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Mood disorders
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Anxiety Disorders
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OCD
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Substance abuse
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Schizophrenia
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Personality disorders (Cluster B - dramatic, erratic)
Frage 24
Frage
Medication of choice for bulimia nervosa is
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Anticonvulsants
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SSRIs
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Atypical antipsychotics
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TCA's
Frage 25
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Combined pharmacotherapy and psychotherapy appears to be more efficacious than either alone for bingeing and purging. This should be continued for a minimum of
Antworten
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6 months
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12 months
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18 months
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2 years
Frage 26
Frage
Which is considered 1st line for bulimia nervosa due to its efficacy and FDA approval for adults
Antworten
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Fluoxetine
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Sertraline
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Citalopram
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Paroxetine
Frage 27
Frage
TCAs and anticonvulsants have been shown in studies to help reduce beingeing and purging, but SSRI Fluxetine is considered first line SSRI therapy
Antworten
- True
- False
Frage 28
Frage
Mechanism of action for Fluoxetine used in bulimia nervosa is
Antworten
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inhibition of 5HT receptor, which leads to an increase in serotonin level
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inhibiting the neuronal reuptake of the neurotransmitters norepinephrine and serotonin. It binds the sodium-dependent serotonin transporter and sodium-dependent norepinephrine transporter reducing the reuptake of norepinephrine and serotonin by neurons
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Combination of antagonism at D2 receptors in the mesolimbic pathway and 5HT2A receptors in the frontal cortex.
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enhances the effects of GABA by increasing GABA affinity for the GABA recepto
Frage 29
Frage
Fluoxetine is contraindicated in use with the following drugs
Antworten
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Selegeline
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Pimozide
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Lithium
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Lorazepam
Frage 30
Frage
When prescribing SSRI Fluoxetine, need to consider other medications that have risk for serotonin syndrome
Antworten
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Triptans
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Other antidepressants
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5-HTP
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St. John's Wort
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Anticonvulsants
Frage 31
Frage
Which anticonvulsants are used off label to treat Bulimia Nervosa
Antworten
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Topiramate
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Zonisamide
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Valpromide
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Primidone
Frage 32
Frage
What is the MOA for Topiramate which is used off label for bulimia nervosa
Antworten
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Inhibits CNS neuronal uptake of serotonin
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
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Blocks voltage- dependent sodium & calcium channels
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GABA activity and antagonizes glutamate receptors
Frage 33
Frage
Binge eating disorder (BED) is the most common ED and almost as common in men as women. Age of onset is 18 years
Antworten
- True
- False
Frage 34
Frage
Select the other comorbid disorders of Binge Eating Disorder
Antworten
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Other ED's
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Schizophrenic disorders
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Mood disorders (MDD, BPD)
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Anxiety disorders
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PTSD
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Elevated risk of suicide
Frage 35
Frage
What medications are used for Binge Eating Disorders (BED)?
Antworten
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SSRI's
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Mood stabilizers
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Stimulants
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Antipsychotics
Frage 36
Frage
Topiramate, a mood stabilizer, has some evidence to suggest it is effective in which eating disorders
Antworten
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Anorexia nervosa
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Binge Eating Disorder
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Bulimia Nervosa
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Avoidant Restrictive Feeding Intake Disorder (ARFID)
Frage 37
Frage
What are some of the concerns in using Topiramate (Topamax) for BN and BED
Antworten
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May trigger restriction and development of AN
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Adverse S/E including sedation and cognitive slowing
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Risk of EPS
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Orthostatic hypotension
Frage 38
Frage
What is the MOA for Topiramate (Topamax)?
Antworten
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GABA activity and antagonizes glutamate receptors. Inhibits carbonic anhydrase
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Non-selectively antagonizes central and peripheral histamine H1 receptors
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
Frage 39
Frage
Which drug interactions does a prescriber need to be concerned about with Topiramate (Topamax)?
Antworten
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Avoid with other sedating medications
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Anything with CNS depression
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Medications with potential to increase risk of metabolic acidosis
Frage 40
Frage
What is the first FDA-approved medication to treat moderate to severe binge eating disorder?
Antworten
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Atomoxetine
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Lixdexamfetamine
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Methylphenidate
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Dextroamphetamine
Frage 41
Frage
What are some concerns with using Lisdexamfetamine for BED?
Antworten
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Risk of misuse or diversion
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Numerous drug interactions that can increase CV events
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Can cause EPS in high doses
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Can cause constipation
Frage 42
Frage
What is the MOA for Lisdexamfetamine?
Antworten
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Stimulates CNS activity (sympathomimetic)
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Selectively inhibits serotonin reuptake resulting in enhanced serotonergic transmission in the CNS
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
-
Interacts with GABA receptors to enhance GABA effects
Frage 43
Frage
Avoidant Restrictive Feeding Intake Disorder (ARFID) is more predominant in males than females and has a younger age of onset, 11, than other EDs
Antworten
- True
- False
Frage 44
Frage
Which are true about ARFID?
Antworten
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Most common comorbidities are anxiety disorders, OCD, and neurodevelopmental disorders (autism, ADHD and intellectual disabilities)
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More common in households with high anxiety
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Some medical conditions are associated including GERD, GI problems, vomiting
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Common with Personality Disorders Cluster B (dramatic, erratic)
Frage 45
Frage
Common comorbid illnesses for ARFID include:
Antworten
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Anxiety disorders (GAD)
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OCD
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Autism spectrum disorder
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Learning disorders
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Mood disorders
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Schizophrenia
Frage 46
Frage
Which appetite stimulants are used to treat ARFID?
Antworten
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Cyproheptadine
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Cathine
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Chlorphentermine
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Diethylpropion
Frage 47
Frage
What is the MOA for Cyrpoheptadine?
Antworten
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Non-selectively antagonizes central and peripheral histamine H1 receptors
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Low affinity for D2 receptors/High affinity for serotonin receptors (5HT2A)
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Inhibits CNS neuronal uptake of serotonin
Frage 48
Frage
Which drugs does Cyproheptadine interact with?
Antworten
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SSRI
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MAOIs
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TCAs
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Anticonvulsants
Frage 49
Frage
The following are symptoms of disordered eating
Antworten
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Picky eating – limited food choices, texture
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Unhealthy dieting – calorie restriction
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Unhealthy eating – skipping meals
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Use of laxatives, diet pills, bingeing, vomiting
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Related to choking fears
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Related to food allergies
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Related to emetaphoibia
Frage 50
Frage
What are symptoms of disordered eating as related to OCD?
Antworten
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Contamination (foods, stores, brands of food, contact with certain people, organic or “green” foods, avoidance of fast foods)
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Color of foods (need to eat all tan foods/avoid red foods – devil or blood)
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Symmetry related (need to eat same amount as sibling to maintain identical weight and shape or chewing same number of times on each side of mouth)
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Use of laxatives, diet pills, bingeing, vomiting
Frage 51
Frage
What are the guidelines for prescribing for disordered eating due to OCD?
Antworten
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Typically require higher doses as compared to patients with affective disorders or other anxiety disorders
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May take 10-12 weeks in OCD to determine efficacy
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Empirical data supports pharmacologic treatment of OCD
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Multiple augmentation strategies for treatment-resistant OCD
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Having your mom tell you to "just eat already" while pinching your cheek
Frage 52
Frage
The following types of drugs are used in the treatment of eating disorders due to OCD
Antworten
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SSRIs
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TCA
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Atypical antipsychotics
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Mood stabilizers
Frage 53
Frage
These are pearls from Mary Carter about the treatment of EDOs
Antworten
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Patients with ED’s are more susceptible to adverse side effects, especially if they are purging or if they are at a low weight. START LOW AND GO SLOW!
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Psychotropic medications do not work as well when nutrition status is poor.
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Malnutrition may deplete trytophan which is necessary to make neurotransmitters like serotonin
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Patients may begin to experience side effects when they are adequately weight restored possibly due to surge in neurotransmitters
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Goal is to get to a dose that optimizes clinical efficacy while minimizing adverse effects
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