Antipsychotic Agents & Lithium Flashcards
Examples of positive symptoms of Schizophrenia
- hallucinations
- conceptual disorganization
- Unusual thought content
Examples of negative symptoms of Schizophrenia
- Anhedonia
- Avolition
- Alogia
- Flattened affect
Which antipsychotic drug is associated with QTc prolongation?
Thioridazine (1st gen)
Which antipsychotic drug was made first and is associated with weight gain?
Chlorpromazine (1st gen)
Which two second generation antipsychotics need to be taken with food?
Lurasidone and Ziprasidone
Which second gen antipsychotic is associated with altered blood counts?
Clozapine (so check plasma levels before exceeding 600mg)
- Agranulocytosis
- Sialorrhea (excess drooling)
Pharmacokinetics of antipsychotics
- well absorbed
- lipid soluble
- extensively protein bound
- metabolized by liver
- Long plasma half-lives
What is haloperidol often paired with right off the bat to hopefully avoid extrapyramidal side effects?
Benztropine (antimuscarinic)
What are the goals of treatment of schizophrenia in the first week?
- decreased agitation, hostility, anxiety, aggression
- normalization of sleep and eating
How long should antipsychotic medication be continued after the first psychotic episode?
at least 12 months
When stopping antipsychotics, esp clozapine, what is important to remember?
taper slowly to avoid cholinergic rebound (1-2 week taper)
Lithium indication
- treat the manic phase in Bipolar disorder
- Lithium has slow onset
When taking lithium, what electrolyte must be monitored?
Sodium (Na+)
lithium replaces sodium in the body
Lithium: MOA
- reduces excitatory neurotransmitters like glutamate and dopamine
- increases inhibitory neurotransmission (GABA)
Lithium: metabolism and excretion
- No metabolism
- Excreted entirely in urine
