Antipsych Flashcards
60y/o on 6mg risperidone, 50mg sertraline. Slowed thinking, drooling, cog-wheeling, masked facies. Mood/paranoia improved on meds. What to do? (5x)
DECREASE DOSE OF THE ANTIPSYCHOTIC
How do antipsychotic meds elevate prolactin (PRL)? (5x)
PROLACTIN IS UNDER TONIC INHIBITORY CONTROL BY DOPAMINE
25 y/o pt hospitalized for an acute psychotic break, begins to complain of thickened speech. Physical exam reveals eyes deviated to the upper right, grimacing, and posturing of the arms. The only meds taken were haldol and clonazepam. The most helpful treatment at this point would be: (3x)
DIPHENHYDRAMINE
25 y/o pt receives haldol and develops laryngospasm: Tx? (2x)
BENZTROPINE
Superior efficacy for atypical antipsychotics over typical antipsychotics in the treatment of psychosis has been consistently demonstrated in what medications? (x2)
CLOZAPINE
Periodically assess neuroleptic side effects using? (it also shows pt’s awareness of side effects) (2x)
AIMS
After an injection with haldol, a patient appears tremulous, dystonic, confused, and has a fever of 38.8 degrees C. Which of the following would be an essential part of the diagnostic workup for this patient? (2x)
CSF EVALUATION
Which med reduces the acute sx of neuroleptic induced akathisia? (2x)
BETA BLOCKERS (PROPRANOLOL, ATENOLOL)
A patient has a seizure secondary to a supratherapeutic level of clozapine. What changes in a patient’s life could account for this finding? (2x)
SMOKING CESSATION
What did the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) demonstrate about effectiveness of 2nd gen. antipsychotics for tx of schizophrenia? (2x)
SECOND GEN. ANTIPSYCHOTICS WERE NO MORE EFFECTIVE THAN FIRST GENERATIONS
These symptoms make a diagnosis of NMS more likely than other neurological and general medical conditions: (x2)
FEVER AND SEVERE MUSCLE RIGIDITY
55 y/o psychiatrically hospitalized pt with chronic schizophrenia stabilized on Clozapine. Two weeks after d/c pt p/w impending signs of psychotic relapse. Assuming pt adherence to meds and negative serum/urine tox screens, what is most likely explanation for relapse (x2)?
RESUMPTION OF HEAVY SMOKING
Elderly w/ VH and cognitive decline -> bradykinesia, rigidity, and multiple falls. What to avoid?
HALOPERIDOL
Finish “epidemic” with clozapine in 1975
AGRANULOCYTOSIS
mech for Qtc prolongation with neuroleptics
K CHANNEL BLOCKED
Med most helpful in tx of antipsychotic induced drooling?
GLYCOPYRROLATE
psychotropic with mod-severe renal impairment?
PALIPERIDONE
How does abilify reverse neuroleptic induced hyperprolactinemia?
PARTIAL D2 AGONIST
A 75 yo with baseline dementia admitted for new onset confusion, disoriented to time and place, work up negative, started on Haldol. After 3 days pt is much improved and minimally somnolence but still disoriented, what is the next pharmacological treatment approach
D/C HALDOL
Which med has increased risk of hyperglycemia and DM?
OLANZAPINE
What drug is most appropriate in emergency treatment of anticholinergic toxicity?
HALOPERIDOL
Which antipsychotic med is assoc with decreased psychotic sxs, decreased substance use, and increased abstinence in pts with schizophrenia and addictive d/o?
CLOZAPINE
36 y/o F pt w/ schizophrenia has been treated w/ olanzapine is discovered prolactin level : 354ng/ml (normal:3-30).The first action is:
ORDER A PREGNANCY TEST
Previous dual antipsychotic failure. Tolerating Clozapine 200mg for a month. What should be next step in medication management?
CONTINUE CLOZAPINE BY ITSELF
Which antipsychotic med has the largest number of studies supporting its use for Tx of explosiveness and reactive anger in youth?
RISPERIDONE
Antipsychotic drug adrenergic effect causing orthostatic hypotension
?1-BLOCKADE
Which atypical antipsychotic causes least weight gain?
ZIPRASIDONE
What hematological finding necessitates immediate dc of clozaril?
WBC 2000-3000, GRANULOCYTES 1000-1500