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Pharm Exam 1 > Anti Psych > Flashcards

Anti Psych Flashcards

1
Q

Lithium clinical indications

A

bipolar

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2
Q

what is the lithium dosing acute phase?

A

300mg BID/TID increase dose every 4-5days

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3
Q

what is the lithium concentration goal for acute phase dosing?

A

0.8-1 meq/L

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4
Q

how often do we check lithium labs until clinically stable?

A

2x per week

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5
Q

maintenance dose for lithium

A

900-1200mg/d

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6
Q

what is the maintenance lithium concentration?

A

0.6-0.8 meq/L

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7
Q

what labs should you monitor on lithium

A

CBC

BMP-K, Ca, Na

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8
Q

how do we monitor renal function on lithium?

A

checking BUN/CR, UA @ baseline and every 2-3mon for 6 months, then twice a year

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9
Q

how do we monitor TFT on lithium?

A

baseline
2-3mon
6 month
then 2 times a year

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10
Q

what RF increase lithium toxicity risks?

A

renal impairement
elderly
dehydration

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11
Q

major ADR of lithium

A

Nausea
Fatigue
wt gain
polyuria/dypsia

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12
Q

long term ADR of lithuum

A

CKD/ESRD
arrythmias
hypo>hyperthyroid

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13
Q

what drugs can you not use on lithium?

A

HTN drugs–loop/thiazide/spiro/ACEI/ARB

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14
Q

use of chlorpromazine

A

intractable hiccups

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15
Q

haloperidol formulations

A

oral
IV
IM–1x month

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16
Q

use of haloperiodol

A

schizophrenia

emergency sedation for agitated/delirious pts

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17
Q

ADR for haloperidol

A 
hypotension
sedation
EPS
NMS
QT prolongation
increase prolactin
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18
Q

what drug can you not use with haloperidol

A

PD drugs or anti-HTN or CNS depressants

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19
Q

what is colzapine used for?

A

refractory schizo

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20
Q

what drugs are IM that are 2nd gen anti-psychotic

A

risperidone
olanzapine
ariprprazole
paliperidone

21
Q

what 4 2nd gen anti-psychs are depression adjunts?

A

olazapine
Quetiapine
Brexpiprazole
Aripiprazole

22
Q

what is the BB warning for 2nd gen anti psych?

A

increase mortality in dementia related-psychosis and suicidality for depression

23
Q

who should we specifically minimize anti-psych use in?

A

elderly
those w/ depression
insomnia pts

24
Q

what should be monitored while on 2nd gen antipsych?

A

weight
lipids
A1C
BMP–K, Mg

25
Q

how often should we check wt for 2nd gen anti-psych?

A

baseline
1x month for 3 months
then every 3 months

26
Q

how often should we check lipids/A1c?

A

baseline
3 months
then annually

27
Q

how often should we check BMP?

A

baseline

then in ppl @ risk for electrolyte abnormalities

28
Q

ADR for all 2nd gen anti-psych?

A 
sedation
hypotension
increase prolactin
wt gain/DM/dyslipidemia
EPS
29
Q

Colzapine specific ADR

A 
DM
wt gain
QT prolongation
GI hypomotility
myocarditis
angraulocytosis
30
Q

Olanzapine and Colzapine specific ADR

A

worse DM and wt gain drugs

31
Q

iloperidone and ziprasidone specific ADR

A

worse QT prolongers

32
Q

Asenapine specific ADR

A

type 1 hypersensitivity rxn

33
Q

Aripiprazole specific ADR

A

complusive urges–gamble, sex, eating

34
Q

Olanzapine and ziprasidone specific ADR

A

DRESS

35
Q

what drugs should you not combine w/ 2nd gen anti-psych?

A

QT prolongers
CNS depressants
Anti-HTN
anti-cholinergic drugs

36
Q

what are the 3 phases of tx for bipolar

A

acute
continuation
maintenance

37
Q

how is acute severe mania treated?

A

atyp. antipsych + lithium or valproate

38
Q

how is mod/mild mania treated

A

monotherapy of lithium, valpropate, atyp. antipsych

39
Q

how is acute bipolar depression treated?

A

lithium

atypical antipsych

40
Q

what is a maintenance therapy drug for mania

A

lithium

41
Q

what is a maintenance therapy drug for dpression

A

lamotrigine

42
Q

what is a maintenance therapy drug for mania + depression

A

lithium or VPA, CBZ, lamotrigine, atypical antipsych

43
Q

what symptoms don’t go away w/ schizo tx?

A

negative sxs (withdrawl, loss of motivation)

44
Q

what EPS are reversible?

A

acute dystonia
pseudoparkinsonism
akathisia

45
Q

what EPS are NOT reversible

A

tardive dyskinesia

46
Q

1st step in managing EPS

A

reduce dose

47
Q

2nd step in managing EPS

A

switch anti-psych to one w/ less EPS

48
Q

3rd step in managing EPS

A

benzotropine–1st drug to anti-psych parkinsonism

or amantaine

Pharm Exam 1 (9 decks)

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