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Psychopharm > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Extrapyramidal Symptoms

A

Akathisia
Acute dystonic reactions
Parkinsonism

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2
Q

Akathisia

A

Sense of restlessness , agitation, SI
onset = days to weeks

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3
Q

Akathisia treatment

A

Propanolol - 10mg BID, up to 30-90mg daily
Inderal - 60-80mg daily
Benzos - any of them will work

reduce dose of antipsychotic or switch

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4
Q

Dystonia

A

torticollis, laryngospasm, occular crisis
occurs in minutes to hours

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5
Q

Dystonia treatment

A

Benzotropine 1-2mg 1-2x/day
Diphenhydramine 50mg daily

if severe, stop antipsychotic and give above agents IM or IV once or twice to stop the dystonia, then give PO

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6
Q

Parkinsonism

A

bradykinesia, rigidity, tremors, shuffling
onset = 1-2 months

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7
Q

Parkinsonism treatment

A

Benzotropine 1-2mg 1-2x/day
Trihexyphenidyl 2-5mg 1-2x/day
Diphenhydramine 50mg daily

can start benzotropine at the same time as the antipsychotic if they are high risk

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8
Q

Tardive Dyskinesia

A

repetitive, involuntary movements. chewing, rolling tongue, smacking lips

can be permanent
clozapine is only antipsychotic that does not cause this

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9
Q

Tardive Dyskinesia treatment

A

Deutetrabenazine (austedo) 6mg bid for 1 week, than increase by 3mg bid, max 24 mg. take with food
-prolongs qtc, SI, insomnia

valbenazine (ingrezza) 40mg x 1 week, then 80mg
-prolongs qtc, SI, sedation

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10
Q

Neuroleptic malignant syndrome

A

-reduced consciousness
-increased muscle tone
-autonomic dysfunction (HTN, ST, hyperpyrexia, diaphoresis, drooling)

**life threatening emergency

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11
Q

Typical Antipsychotics adverse effects

A

S - sedation, sun sensitivity, sexual side effects
T - tardive dyskinesia
A - anticholinergic, agranulocytosis
N - neuroleptic malignant syndrome
C - cardiac arrhythmias
E - extrapyramidal effects, endocrine effects (^ prolactin levels)

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12
Q

Alogia

A

poverty of speech

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13
Q

Affective blunting

A

reduced range of emotions

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14
Q

Asociality

A

reduced social drive and interaction

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15
Q

Anhedonia

A

reduced ability to feel pleasure

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16
Q

Avolition

A

reduced desire, motivation to complete daily tasks

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17
Q

Positive symptoms come from

A

mesolimbic

18
Q

Negative symptoms come from

A

mesocortical/prefrontal cortex

19
Q

Affective symptoms come from

A

Ventromedical prefrontal cortex

20
Q

Aggressive symptoms come from

A

amygdala & orbitofrontal cortex

21
Q

Cognitive symptoms come from

A

Dorsolateral prefrontal cortex

22
Q

High Potency FGA

A

Haldol, fluphenazine

23
Q

Mid Potency FGA

A

perphenazine, loxapine

24
Q

Low potency FGA

A

chlorpromazine

25
Q

Haloperidal (Haldol)

A

FGA
PO 1-15mg/day MAX 100mg
usual = 1-40mg/day
Decanoate

26
Q

Fluphenazine (Prolixin)

A

FGA
PO 0.5 - 10mg/day MAX 40mg
usual = 1-20mg/day
decanoate

27
Q

Chlorpromazine (Thorazine)

A

FGA
200-800mg/day

28
Q

Loxapine (Loxitane)

A

FGA
20mg/day in 2 doses, titrate over 7-10 days to 60-100mg, max 250mg

29
Q

Perphenazine (Trilafon)

A

FGA
intial = 4-8mg TID
12-24mg/day
16-64mg/day if hospitalized

30
Q

Trifluoperazine (stelazine)

A

FGA
intial = 2-5 mg BID
normal = 15-20 mg/day

31
Q

FGA contraindications

A

-allergic
-ingestion of substances that will interact ex etoh
-severe cardiac abnormality
-high risk for seizure
- narrow angle glaucoma
-history of tardive dyskinesia

caution in liver disease

32
Q

Most sedating antipsychotics

A

olanzapine
clozapine
seroquel

33
Q

Atypical Antipsychotics that cause EKG changes

A

ziprasidone

34
Q

Atypical Antipsychotics that cause EPS

A

risperidone
(Haldol and fluphenazine for 1st gen)

35
Q

Aytpical antipsychotic that causes akathsia

A

ariprazole
brexipiprazole

36
Q

antipsychotics that must be taken with food

A

geodon - 500 cals
lurasidone - 350 cals

37
Q

atypical psychotics that are high risk for metabolic syndrome

A

clozapine
olanzapine

38
Q

atypical psychotics that are medium risk for metabolic syndrome

A

risperidone, paliperidone, seroquel

39
Q

atypical psychotics that are low risk for metabolic syndrome

A

ziprasidone
ariprazole
lurasidone

40
Q

what drug increases prolactin

A

risperidone

41
Q

what drugs come in IV/IM formulation

A

haldol
fluphenazine
aripiprazole
risperidone

42
Q

what drugs come in sublingual formulation

A

olanzapine
asenapine

Psychopharm (2 decks)

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