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NMSP Exam 3 > Anti-Psychotics > Flashcards

Anti-Psychotics Flashcards

1
Q

What is an additional indication for clozapine?

A

Recurrent suicidal behavior

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2
Q

What is the indication for Pimavanserin?

A

Hallucinations/delusions associated with parkinson’s disease psychosis

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3
Q

What are the 2 broad categories that FGA’s are divided into?

A

Low and high potency (based on D2 receptor potency/receptor occupancy)

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4
Q

What are low potency FGA?

A

More sedation, hypotension, tachycardia and ECG changes; seen with chlorpromazine and thioridazine (associated with Torsade’s de pointes and sudden death)

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5
Q

What are high potency FGA?

A

More movement (EPS) and endocrine effects (prolactin); seen with fluphenazine and haloperidol

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6
Q

What is dystonia?

A

Sustained contraction that can develop within hours-days

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7
Q

What can be used to tx dystonia?

A

Anticholinergics such as Benzotropine, Diphenhydramine and Trihexyphenidyl

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8
Q

What is akathisia?

A

Constant movements that can develop within days-weeks of treatment

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9
Q

What can be used to tx akathisia?

A

Beta blocker (propranolol), benzodiazepine (lorazepam) or anticholingergic (benztropine)

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10
Q

What is parkinsonism?

A

Tremor, rigidity and bradykinesia that can develop within weeks to months of tx

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11
Q

What can be used to tx parkinsonism?

A

Anticholinergic agent (benztropine) and dopamine enhancer (amantadine)

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12
Q

What is tardive dyskinesia?

A

Repetitive, uncontrollable movements that can occur within 6 months of tx

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13
Q

What can be used to tx tardive dyskinesia?

A

Selective vesicular monoamine transporter 2 (VMAT2) inhibitors such as Valbenazine or Deutetrabenazine

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14
Q

Which monitoring scale can be used to assess for general sx?

A

Glasgow Antipsychotic Side effect Scale (GASS)

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15
Q

Which screening tool is used to monitor for movement disorder such as TD?

A

Abnormal involuntary movement scale (AIMS)

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16
Q

Which screening tool can be used to monitor for EPS sx?

A

Extrapyramidal sx rating scale (ESRS)

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17
Q

Which screening tool can be used to monitor for akathisia?

A

Barnes akathisia rating scale (BARS)

18
Q

What is a rare but severe side effect that can be seen in all anti-psychotics?

A

Neuroleptic malignant syndrome (NMS)

19
Q

What is neuroleptic malignant syndrome (NMS)?

A

Rare but potentially fatal severe Parkinson’s like movement disorder with wide spread muscle contraction

20
Q

What can be used to tx NMS?

A

Dantrolene which acts on the ryanodine receptor (also diazepam used as indirect tx)

21
Q

Which generation is more commonly utilized as first line inital therapy?

22
Q

What can be used to treat acute agitation in schizophrenia pts?

A

Injectable IR versions of Haloperidol, Ziprasidone, Olanzapine or Aripiprazole; ODT or SL versions also available

23
Q

What is used to tx multi-drug resistant dz?

24
Q

What can be used to tx psychotic pts with suicidal thoughts/behaviors?

25
Q

How is non-adherence managed?

A

With long acting injectable agents (LAIA’s)

26
Q

What are the LAIA’s that can be used in a non-compliant pt?

A

Risperidone, Olanzapine, Aripiprazole lauroxil and Paliperidone palmitate (ROAP)

27
Q

Which SGA’s have the lowest amount of side effects?

A

Aripiprazole, Lumateperone, Brexipiprazole, Iloperidone, and Zipraseridone

28
Q

Which SGA’s have the highest number of side effects?

A

Clozapine and olanzapine

29
Q

Which SGA’s have the highest risk for weight gain?

A

Clozapine and olanzapine

30
Q

Which SGA’s have the lowest risk for weight gain?

A

Aripiprazole, Brexipiprazole, Lumateperone, Lurasidone, Ziprasidone

31
Q

Which SGA’s have the lowest risk for hyperglycemia?

A

Aripiprazole, Brexipiprazole, Cariprazine, Lumateperone, Paliperidone, Ziprasidone

32
Q

Which SGA’s have the greatest riks for hyperglycemia and HLD?

A

Clozapine and olanzapine

33
Q

Which SGA’s have the lowest risk for HLD?

A

Aripiprazole, Cariprazine, Iloperidone, Lumateperone, Ziprasidone

34
Q

Which SGA’s have the lowest risk of EPS sx?

A

Clozapine, Iloperidone, Lumateperone, Quetiapine, Ziprasidone

35
Q

Which SGA’s have the greatest risk for prolactin elevation?

A

Paliperidone and Risperidone

36
Q

Which SGA’s have the lowest risk for sedation?

A

Aripiprazole, Lumateperone, Paliperidone

37
Q

Which SGA’s have the greatest risk for sedation?

A

Cariprazine, Clozapine, Olanzapine, Quetiapine

38
Q

Which SGA’s have the highest risk of anticholinergic side effects?

A

Cariprazine and Clozapine

39
Q

Which SGA’s have the greatest risk of causing orthostatic hypotension?

A

Cariprazine, Clozapine, and Iloperidone

40
Q

Which SGA has the greatest risk of causing QTc prolongation?

A

Ziprasidone

41
Q

Which SGA’s have the lowest risk of causing QTc prolongation?

A

Aripiprazole, Brexipiprazole, Lumateperone, Lurasidone

NMSP Exam 3 (11 decks)

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