Quality measures:
Medicare A: _ (HRRP)
medicare B: _
medicare C & D: STAR measures
commercial payers: _
medicaid: adult core measure set, state-specific measures
hospital readmissions reduction program; quality payment porogram (QPP); HEDIS
for determining rules for reimbursment _ is the gold standard
CMS
physician fee scheduled (PFS), outpatient prospective payment system (OPPS) and MACRA-quality payment program (QPP) are all _ benefit structure rules for beimbursement
medicare
_ (IgE-mediated hypersensitivity) can be caused by clozapine
myocarditis
Avoid lithium if CrCl < _. and titrate slowly if 30-89
30
SNRI require more _ dosing than SSRI.
renal
_ does not work well for panic disorder or OCD. Do not use PRN
buspirone
second line for anxiety disorder if patient fails multiple SSRIs or partial response, add _ or _
TCA; buspirone
SSRI or _ first line for panic disorder
venlafaxine
For PTSD, _, _, and venlafaxine XR are first line in most guidelines
sertraline; paroxetine
Depression:
consider switching over augmentation if patients has not seen _% reduction in symptoms
greater than 50
Aripiprazole, Quetiapine XR, and Brexpiprazole are the SGAs with FDA‑approved indications for _ in depression. olanzapine/fluoxetine combo also.
augmentation
bipolar 2 = hypomanic, 2 is hypo to 1.
for bipolar 1, combination therapy with _ and _ or either of those with an antipsychotic is common
lithium; valproic acid
_ does not provide coverage for mania, most SGA provide coverage for mania
lurasidone
lithium interactions:
-_
-_
-_
-sglt2i
Hyponatremia can _ lithium levels
ACE/ARB; NSAIDs; diuretics; increase
stop _ in acute mania
antidepressants
EPS (AIM scale to assess)
-dystonia
-_ - wanting to move, fidgeting
-pseudoparkinsonism
-TD
akathisia
antipsychotic metabolic risk:
High: _, _
medium: risperidone, paliperidone, iloperidone, quetiapine
low: ziprasidone, aripiprazole, _, asenapine, brexpiprazole, cariprazine, lumateperone
clozipine; olanzapine; lurasidone (low risk)
lacosamide, lamotrigine, levetiracetam, perampanel, topiramate, and valproate are all _ spectrum agents use to treat focal and generalized siezures
broad
Moderate inducers:
oxcarbazepine at doses > _ mg
topiramate at doses > _ mg
1200; 200
These antiepilleptics do not inhibit/induce CYP at any dose:
-_
-_
-gabapentin
-pregabalin
levetiracetam; lamotrigine
Serum lamotrigine levels in patients recieving concomitant _ were approximately double
valproic acid
antiepileptics:
- avoid _ in obesity
valproate
antiepileptic Side effects:
-cabamaz, oxcarbaz: _ (OXC >BCZ)
-lacosamide: prolonged PR interval
-_: gingival hyperplasia, nystagmus
-_ and zonisamide: paresthesias, oligohidrosis (decreased ability to sweat), kidney stones
-_: tremor, hepatotoxicity, PCOS
-cenobamate/_: DRESS/RASH
hyponatremia; phenytoin; topiramate; lamotrigine
