Antipsychotics

Question 1

What make up the first generation antipsychotics?

Answer 1

Phenothiazines
Thioxanthenes
Butyrophenones

Question 2

What are the Group 1 Phenothiazines

Answer 2

Chlorpromazine
Levopromazine
Promazine

Question 3

What are the Group 2 Phenothiazines

Answer 3

Priciazine

Question 4

What are the Group 3 Phenothiazines

Answer 4

Prochlorperazine
Fluphenazine
Trifluperazine

Question 5

What are Thioxanthines?

Answer 5

Flupentixol
Zuclopentixol

Question 6

What are Butyrophenones?

Answer 6

Haloperidol
Benperidol

Question 7

What are the other first generation antipsychotics?

Answer 7

Pimozide
Sulpride

Question 8

What are the second generation antipsychotics?

Answer 8

Amisulpride, ariprazole, olanzapine, Risperidone, clozapine, quetiapine

Question 9

What are the most sedating antipsychotics?

Answer 9

Group 1 e.g. Chloropromazine, Levopromazine and promazine

Question 10

What ones have moderate sedation?

Answer 10

All the other first generation antipsychotics, minus the ‘other’

Question 11

Which ones have the highest extra pyramidal side effects?

Answer 11

Prochlorperazine, Fluphenazine, Trifluoperazine (group 3)
Benperidol and Haliperidol

Question 12

Which ones have antimuscarinic effects?

Answer 12

Group 1: Chlopromazine, levopromazine and promazine
Flupentixol, Zuclopentixol

Question 13

Which generation has the least side effects?

Answer 13

Second generation

Question 14

Which antipsychotics prolong the QT interval?

Answer 14

Haloperidol and Pimozide

Question 15

Which antipsychotic has the lowest incidence of lactation?

Answer 15

Ariprazole

Question 16

Which antispychotics cause Hypotension?

Answer 16

Clozapine and Quetiapine
(Quite Close to the GROUND)

Question 17

Which antipsychotics cause Hyperglycaemia?

Answer 17

Clozapine, Risperidone, Olanzapine and Quetiapine
(CROQ has the sweetest flavours)

Question 18

Which antipsychotics cause weight gain?

Answer 18

Olanzapine, Cloxapine
(Too much time with a WOC)

Question 19

What is a MHRA warning with all antipsychotics?

Answer 19

Neuroleptic malignant syndrome

Question 20

What should you do if someone has neuroleptic malignant syndrome?

Answer 20

Stop treatment
Treat with Bromocriptine
Should resolve within 5-7 days

Question 21

Which antipsychotics have a stroke risk?

Answer 21

Risperidone and Olanzapine
stROke

Question 22

When should antipsychotics be monitored?

Answer 22

At the start, at 12 weeks, at 1 year and then yearly

Question 23

What should be monitored?

Answer 23

ECG (Haloperidol and pimozide)
BP
FBC
U&E’s
LFT’s

everything except tft’s

Question 24

When should Clozapine be used?

Answer 24

In resistant schizophrenia when two or more antipsychotics have been used including one second generation, and has been used for 6-8 weeks.

Question 25

How many doses of clozapine can be missed before specialist reinitiating is needed?

Answer 25

2 doses

Question 26

How often should blood counts be done for clozapine?

Answer 26

Weekly for 18 weeks
Fortnightly for one year
Monthly thereafter

Question 27

How often should blood counts be done for clozapine?

Answer 27

Weekly for 18 weeks
Fortnightly for one year
Monthly thereafter

Question 28

What are the side effects of Clozapine?

Answer 28

MAGIH
Myocarditis and cardiomyopathy: Report and stop on tachycardia
Agranulocytosis and Neutropenia: Monitor leucocyte and differential blood counts as prev mmentioned
Gastrointestinal disturbances: Report and stop on constipation - intestinal block.
Hypersalivation

Question 29

what are the blood tests needed for clozapine monitoring?

Answer 29

Leucocyte and differential blood counts.
Body weight and blood lipids
Blood glucose

Question 30

What antipsychotics can have reported sexual dysfunction?

Answer 30

All of them

Question 31

Symptoms of neuroleptic malignant syndrome

Answer 31

High fever, sweating, unstable blood pressure