Antipsychotics

Question 1

What do antipsychotics do?

Answer 1

Have an immediate quieting effect in acute psychosis

Question 2

Do antipsychotics delay relapses?

Answer 2

Yes

Question 3

What are two indications for antipsychotics aside form the quieting effect?

Answer 3

1. sedation (when benzo’s are contraindicated) 2. movement disorders (hunting tons/tourettes)

Question 4

Are antipsychotics chosen based on efficacy or SE profile

Answer 4

SE profile

Question 5

Low potency antipsychotics have the highest risk of causing _____ ______ (alpha blockade), dry mouth, acute _____ ______, blurry vision and _______ (anticholinergic)

Answer 5

Alpha blockade = orthostatic hypotension. Anticholinergic = acute urinary retention, delirium, dry mouth and blurry vision

Question 6

Thioridiazine is associated with _________ __ and _____.

Answer 6

Prolonged QT and arrythmias

Question 7

Thoridiazine is associated with _____ _____ pigmentation.

Answer 7

Abnormal retinal pigmentation. Routine eye exam for chronic therapy

Question 8

What are common reasons for noncompliance in males on antipsychotics? (alpha blockade effects)

Answer 8

impotence and inhibition of ejaculation

Question 9

What are common reasons for noncompliance in female on antipsychotics? (hyperprolactinemia)

Answer 9

weight gain. Also ask about galactorrhea and amenorrhea

Question 10

What is an adverse effect of clozapine and what should you test?

Answer 10

agranulocytosis. CBC and diff before starting and during therapy.

Question 11

Haloperidol is a _____ potency _____ (typical/atypical) antipsychotic.

Answer 11

Haldol = high potency/ typical

Question 12

____ (antipsychotic) is less sedating, fewer anticholinergic effects, less hypotension, has depot injections available

Answer 12

Haldol

Question 13

____ has the greatest association with extrapyramidal systems (EPS)

Answer 13

Haldol

Question 14

Chlorpromazine is a ____ (atypical/typical) ____ potency (low/high) antipsychotic

Answer 14

Chlorpromazine = typical, low potency

Question 15

Chlorpromazine is _____ (less/more) likely to cause EPS.

Answer 15

Chlorpromazine = less likely than haldol

Question 16

________ has high anticholinergic effects, more sedation and more postural hypotension than haldol.

Answer 16

Chlorpromazine = increase anticholinergic, increase sedation, increase postural hypotension

Question 17

Risperidone, olanzapine, quetiapine, clozapine are _____ (typical/atypical) antipsychotic.

Answer 17

atypical antipsychotics; Risperidone, olanzapine, quetiapine, clozapine

Question 18

_____ (atypical/typical) antipsychotics are the drug of choice for initial therapy; what are some examples.

Answer 18

atypical; Risperidone, olanzapine, quetiapine, clozapine

Question 19

_____ (atypical/ typical) antipsychotics have greater effect on negative symptoms and little or no risk of EPS

Answer 19

Atypical;Risperidone, olanzapine, quetiapine, clozapine

Question 20

When is clozapine used and why?

Answer 20

treatment resistant patients because of risk of agranulocytosis

Question 21

A newly diagnosed schizophrenic patient complains of insomnia. What is the most appropriate antipsychotic to initiate therapy?

Answer 21

olanzapine, quetiapine, ziprasidone, aripiprazole are first choice when insomnia is a problem

Question 22

A schizophrenic patient has been maintained on olanzapine for the past 6 months. He complains of daytime sedation, and he has lost 2 jobs in the past month because of impaired performance. What is the next step in management?

Answer 22

Risperidone, a first choice tx option when sedation is an issue.

Question 23

______ (drug) affects 5HT, D1, D2, alpha 1, alpha 2, H1

Answer 23

Risperidone

Question 24

What 6 receptors does risperidone affect?

Answer 24

5HT, D1, D2, alpha 1, alpha 2, H1