Anti-psychotics and Mood Stabilizers Flashcards

1
Q

Antipsychotics

A

Used to treat bipolar and schizophrenia

May be more effective monotherapy than mood stabilizers

1st generation cause EPS - Treat with Cogentin

EPS SE: tardive dyskinesia, neuroleptic malignant syndrome

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2
Q

1st Generation Antipsychotics

A

Haloperidol (Haldol), Chlorpromazine (Thorazine)

Effective in treating positive sx schizophrenia but not significant recovery and serious SE

SE: Akathisia, EPS, Parkinsonian-like rigidity/tremor

Check CPK for muscle breakdown

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3
Q

Dyskinesia

Akathisia

Dystonia

And treatment

A

Dyskinesia = repetitive, involuntary, purposeless movements

Akathisia = internal/external restlessness

-can’t sit still, jitteriness, shaky with suicidal ideation

Dystonia = very strong muscular contractions causing abnormal posturing

Treat w/ Cogentin - blocks Ach to reestablish Ach and Dopamine balance

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4
Q

2nd Generation Antipsychotics

A

Less SE, effective in treatment of negative sx

SE: Monitor for glucose intolerance, causes weight gain

-apine, -idone, -prazole

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5
Q

2nd generation antipsychotic

Weight gain is major SE

Levels decreased w/ smoking

A

Olanzapine (Zyprexa)

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6
Q

2nd generation antipsychotic

Major SE is drowsiness, hyperprolactinemia

Tx mood and anxiety disorders, PTSD, Parkinsons

A

Quetiapine (Seroquel)

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7
Q

2nd generation antipsychotic

less weight gain - people typically like it

A

Ziprasidone (Geodon)

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8
Q

2nd generation antipsychotic

Major SE is agranulocytosis - monitor CBC

Also weight gain

Effective in treatment resistant patients

A

Clozapine (Clozaril)

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9
Q

2nd generation antipsychotics

Very expensive

Unique, unpredictable effect on other antipsychotic activity

A

Aripiprazole (Abilify)

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10
Q

Mood Stabilizer

1st line for bipolar with 2nd gen antipsychotic

Low therapeutic index - requires constant level monitoring 12 hours after last dose

Check for renal and thyroid toxicity

Pregnancy D

Can cause serotonin syndrome

A

Lithium

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11
Q

Mood Stabilizer - anticonvulsant

1st line for bipolar acute depression - doesn’t trigger mania

SE: Steven Johnsons Syndrome

Not for acute mania - only used after manic episode resolves

A

Lamotrigine (Lamictal)

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12
Q

Mood Stabilizer - anticonvulsant

1st line for bipolar disorder manic episode + 2nd gen antipsych

Less SE than lithium

BBW: Hepatotoxicity

Quick onset w/ large therapeutic window

Monitor pancreas, liver (BBW), and pancytopenia

A

Valproate (Depakote)

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13
Q

Mood stabilizer - anticonvulsant

Efficacy comparable to lithium

Narrow Therapeutic window

Check levels, CBC, thyroid, and LFTs

BBW: Steven-Johnsons Syndrome

Category X for pregnancy - teratogen

A

Carbamazepine (Tegretol)

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14
Q

2nd generation antipsychotics

Most commonly used

No anticholinergic effects

A

Risperidone (Risperdal)

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15
Q

Alprazolam

A

Xanax

long onset - 1 hour

11-15 hour half life - short

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16
Q

Clonazepam

A

Klonopin

shorter onset - 0.5-1 hour

18-50 hour half life

17
Q

Diazepam

A

Valium

Quickest onset - 0.25-0.5 hours

50-100 hour half life - long

18
Q

Lorazepam

A

Ativan

quicker onset - 0.5-1 hour

10-14 hour half life - short