Antipsychotic Jeopardy

Question 1

Chlorpromazine

Thorazine

Answer 1

first antipsychotic (LOW potency)
first psychotropic

anti-cholinergic
antihistaminic
a1 adrenergic antagonist

TX: intractable hiccups

Question 2

High vs Low potency

Answer 2

antipsychotics differ in the D2 receptor binding affinity

Question 3

Haloperidol

Haldol

Answer 3

TX: agitation in ER/hospital; tourette’s sx

PO, IM, IV

Question 4

EPS side effect

Answer 4

Trihexyphenidyl
benztropine
Diphenhydramine
(Benadryl)

Question 5

TX chronic schizophrenia

Answer 5

Haloperidol + Fluphenzanine

FGAs given IM every 2-4 hrs

Question 6

Prochlorperazine

Compazine

Answer 6

D2 blocker

ANTIEMETIC > antipsychotic use

Question 7

Thioridazine

Mellaril

Answer 7

INC risk dose dependent:
QTc prolongation
torsades de pointes
cardiotoxicity

Question 8

Clozapine

Clozaril

Answer 8

most efficacious but lots of AE

Metabolic syndrome
Seizure induction - slow titration

Abrupt Stop: WBC

Question 9

Quetiapine

Seroquel

Answer 9

TX: Lewy body dementia, Parkinson’s
approved for bipolar depression

low risk of EPS

Question 10

Risperidone

Answer 10

AE: Prolactin Elevation

Question 11

Olanzapine

Zyprexa

Answer 11

AE: metabolic syndrome (check glucose, lipids)

Question 12

Ziprasidone

Geodon

Answer 12

SGAs

AE: QTc prolongation

Question 13

Aripiprazole

Abilify

Answer 13

SGA
partial Dopamine agonist

TX: adjunct of major depression

AE: akathisia

switching to aripiprazole (abilify) from a different antipsychotic, before the other antipsychotic has WASHED OUT, abilify—at least in theory— initially does is D2 receptors AGONIST

Question 14

metabolically “NeutrAALZ”

Answer 14

Aripiprazole
Asenapine
Lurasidone
Ziprasidone

Question 15

Tardive Dyskinesia

Answer 15

AE typical antipsychotic

repetitive involuntary purposeless movement

Question 16

Dystonia

Answer 16

Neck sx of EPS

INC risk young males

Question 17

orthostatic hypotension

Answer 17

a1 adrenergic antagonism
(risk for elderly, inc fall)

Clozapine
Iloperidone
Paliperdione
Quetiapine
Risperidone

Question 18

blackbox warning antipsychotic - Eldery

Answer 18

sudden death

cardiovascular

Question 19

oculogyric crisis

Answer 19

AE of antipsychotic

prolonged bilateral elevation of the visual gaze

Question 20

gynecomastia

Answer 20

bc hyperprolactinemia

D2 blocker AE

Question 21

SGAs block?

Answer 21

D2, 5HT2a receptor

Question 22

Mesolimbic Pathway hyperactivity effects?

Answer 22

+sx of schizophrenia

Question 23

Tubuloinfundibular Pathway excess bockade?

Answer 23

Infertility
galactorrhea
osteopenia

Question 24

NMS

Answer 24

bc Dopamine Antagonism
rare (.02 - 3%)

1st sx - mental status changes
muscular rigidity
hyperthermia
autonomic stability

Question 25

Mesocortical Pathway Hypoactivity?

Answer 25

NEGATIVE sx

Question 26

D2 blocker + EPS, + TD

Answer 26

antiemetic medication Prochlorperazine Droperidol Metoclopramide Promethazine

Question 27

Cigarette smoking

Answer 27

INC metabolic rate of antipsychotic meds do 75% of schizophrenia pts

Question 28

Creatine Kinase

Answer 28

correlates with NMS severity and prognosis may be normal in well developed rigidity

Question 29

TX: bipolar depression

Answer 29

Olanzapine/fluoxetine (symbyax) Lurasidone (latuda) Quetiapine (seroquel)

Question 30

Paliperidone

Answer 30

atypical AE: hyperprolactinemia active metabolite of risperidone WITH FOOD

Question 31

Long acting injectable SGAs

Answer 31

Risperidone Olanzapine Paliperidone Aripiprazole

Question 32

H1 AE

Answer 32

sedation | weight gain