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NMSP - Exam 3 > 2nd Generation Antipsychotics > Flashcards

2nd Generation Antipsychotics Flashcards

1
Q

What are the 1st line choices for Antipsychotics?

A

2nd generations!

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2
Q

What is the MOA for most of the 2nd Generation agents?

A

Block 5-HT AND D2

– more serotonin blocking than dopamine blocking

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3
Q

What is good about the 2nd generation agents blocking 5-HT2 more so than blocking D2?

A

LESS extrapyramidal symptoms and tardive dyskinesia

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4
Q

What 5 agents are 5-HT2/DA ANTAGONISTS?

A 
-idones!
Iloperidone
Lurasidone
Paliperidone
Risperidone
Ziprasidone
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5
Q

What 5 agents at 5-HT2/DA ANTAGONISTS?

A 
Iloperidone
Lurasidone
Paliperidone
Risperidone
Ziprasidone
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6
Q

If the 2nd generation agent ends in -idone, what is its MOA?

A

5-HT(2) and DA ANTAGONIST

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7
Q

What is a side effect of Ziprasidone?

A

ECG changes

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8
Q

Lurasidone is a 5HT2/DA ANTAGONIST. What is its extra MOA?

A

5-HT1 AGONIST

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9
Q

What 3 agents are 5-HT2/DA ANTAGONISTS and partial D2/5-HT1 AGONISTS?

A

Aripiprazole
Brexpiprazole
Cariprazine

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10
Q

What 3 agents are 5-HT2/DA ANTAGONISTS and partial 5-HT1/D2 AGONISTS?

A

Aripiprazole
Brexpiprazole
Cariprazine

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11
Q

What is the MOA for Aripiprazole, Brexpiprazole and Cariprazine?

A

5-HT2/DA ANTAGONISTS

5-HT1/D2 AGONISTS

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12
Q

What 5 agents are MULTI-acting?

A 
Asenapine
Clozapine
Olanzapine
Quetiapine
Lumateperone
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13
Q

What 5 agents are MULTI-acting?

A 
Asenapine
Clozapine
Olanzapine
Quetiapine
Lumateperone
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14
Q

If the 2nd generation agent ends in -apine, what is its MOA?

A

MULTI-acting

– also Lumateperone

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15
Q

What general side effects ca be seen with the Multi-acting agents Clozapine and Olanzapine specifically?

A

Weight gain

Increased glucose and lipid levels

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16
Q

What 2 Multi-acting agents can cause weight gain and elevated glucose/lipids?

A

Clozapine

Olanzapine

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17
Q

What should you get on the patient before starting a 2nd generation agent?

A

BASELINE weight, BP, glucose and lipid levels

– check at 12 weeks after starting

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18
Q

What specific (2) adverse effects can occur with Clozapine use?

A

Agranulocytosis

Seizures

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19
Q

What specific (2) adverse effects can occur with Clozapine use?

A

Agranulocytosis

Seizures

20
Q

What specific (1) adverse effect can be seen with Olanzapine use?

A

Eosinophilia and systemic symptoms

21
Q

What is a Serotonin Inverse Agonist?

A

Pimavanserin

22
Q

What is a Serotonin Inverse Agonist?

A

Pimavanserin

23
Q

The 2nd generation agents have what risk with elderly dementia patients?

A

Stroke

24
Q

2nd generation agents can cause what syndrome?

A

Neuroleptic Malignant Syndrome

25
Q

Neuroleptic Malignant Syndrome

A

Parkinson like movements with muscle contractions

26
Q

What receptor opens with Neuroleptic Malignant Syndrome?

A

Ryanodine receptor opens
– Calcium efflux
=> parkinson like movements with wide spread muscle contractions

27
Q

What are the 2 antidote options for Neuroleptic Malignant Syndrome?

A

Dantrolene

Diazepam

28
Q

What are the 2 antidote options for Neuroleptic Malignant Syndrome and their MOA?

A

Dantrolene - closes ryanodine receptor

Diazepam - peripheral muscle relaxation

29
Q

What are 4 things you can use to monitor antipyschotic use?

A

GASS
AIMS
BARS
ESRS

30
Q

GASS antipsychotic monitoring

A

Overall side effect scale

31
Q

AIMS antipsychotic monitoring

A

Abnormal Involuntary Movement Scale

32
Q

BARS antipsychotic monitoring

A

Akathisia scale

33
Q

ESRS antipsychotic monitoring

A

Extrapyramidal symptom scale

34
Q

What does Pimavanserin treat?

A

Parkinson disease Psychosis

35
Q

What treats Parkinson disease Psychosis?

A

Pimavanserin

36
Q

What drug can treat suicidal thoughts/behaviors?

A

Clozapine

37
Q

What drug can treat multi-drug resistant psychoses?

A

Clozapine

38
Q

There are 4 agents that can be given via injection for acute agitation. What are they?

A

Haloperidol
Ziprasidone
Olanzapine
Aripiprazole

39
Q

There are 4 agents that can be given via injection for acute agitation. What are they?

A

Haloperidol
Ziprasidone
Olanzapine
Aripiprazole

40
Q

How can you manage NON-adherence?

A

Long acting injectable agents

41
Q

What do long acting injectable agents manage?

A

Non-adherence

42
Q

What 1st generation agents (2) can be used as long acting injectable agents?

A

Haloperidol

Fluphenazine

43
Q

What 1st generation agents can be used as long acting injectable agents?

A

Haloperidol

Fluphenazine

44
Q

What 2nd generation agents (4) can be used as long acting injectable agents?

A

ROAP

  • Risperidone
  • Olanzapine
  • Aripiprazole
  • Paliperidone
45
Q

What 2nd generation agents can be used as long acting injectable agents?

A

ROAP

  • Risperidone
  • Olanzapine
  • Aripiprazole
  • Paliperidone

NMSP - Exam 3 (22 decks)

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