4 Antipsychotics Flashcards
Cautions with clozapine (3)
Agranulocytosis - check WBC counts. Patients should report symptoms of infection esp influenza like illness
Myocarditis and cardiomypathy - esp in first two months. (investigate before starting therapy. Monitor if tachycardic)
Intestinal obstruction - caution in patient taking constipating drugs. Recognize and treat constipation stat
Clozapine should be used in caution in patients taking drugs that cause…………….. such as………..
and drugs that might also cause
constipation
anti-muscurinics
agranularcytosis
How are the metabolic side-effects of anti psychotics measured?
monitor lipids and fasting blood glucose
Clozapine is typical or atypical
atypical (second gen)
If EPS side-effects are a particular concern use 1st or 2nd gen?
Second (atypical)
How long should an anti psychotic be tried for before it is deemed ineffective?
4-6 weeks
When is clozapine indicated?
two or more anti-psychotics have been tried (at least one of which was second gen)
main advantage of depot?
compliance
disadvantage of depot?
higher risk of EPS
Why do ECGs for antipsychotics
risk of prolonged QT interval
Caution when prescribing IM anitpsychotics for emergencies
The IM dose should be lower than oral (no first-pass effect), especially if pt is active (bloodflow to muscles increases absorbtion rate)
therefore Rx should not say route: PO/IM
What is neuroleptic malignant syndrome?
Rare and potentially fatal side-effect of antipsychotics
hyperthermia, fluctuating consciousness, muscle rigidity, pallor, tachycardia, labile BP, urinary incontinence
