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Chapter 18 Psychotropic > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Amisulpride (Solian)

A

A) Anti-Psychotic

B)
1. Schizophrenia

C)
100-400 mg BD
Max 1200 mg daily (in 2 doses)

D)

  1. QT prolongation**
  2. BP (minimal)
  3. Lipids
  4. Full BLOOD count
  5. Blood GLUCOSE
  6. WEIGHT (minimal)
  7. LIVER function tests
  8. RENAL** (reduce dose)
  9. Clinical Improvement
  10. PROLACTIN (increase)***

E)
Labels: 1, 7b (oral solution), 12, 16
#Take REGULARLY to prevent risk of RELAPSE
#Might take 1-2 weeks before you notice a difference. Doctor may ask you to TRIAL for 2-3 months
#Consider whether a REGULAR INJECTION may suit you
#Avoid taking ILLICIT substances (increases risk of relapse)
S/E:
*Insomnia and Hypersalivation
*PROLACTIN (increase)**

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2
Q

Aripiprazole (Abilify)

A

A) Anti-psychotic

B)

  1. Schizophrenia
  2. Bipolar disorder (monotherapy)
  3. Acute mania (combination)

C)

tab: 10-30 mg ONCE daily
inj: ONCE a month (200-300mg)

D)
(good S/E profile all round)
1. BP (minimal)
2. Lipids
3. Full BLOOD count
4. WEIGHT (minimal)
5. QT interval (little effect)
6. Blood GLUCOSE (minimal)
7. LIVER function tests** (avoid in injection)
NO renal

E)
Labels: 1, 16+
#Take REGULARLY to prevent risk of RELAPSE
#Might take 1-2 weeks before you notice a difference. Doctor may ask you to TRIAL for 2-3 months
#Consider whether a REGULAR INJECTION may suit you
#Avoid taking ILLICIT substances (increases risk of relapse)
S/E:
Headache, Akathisia, Light-headedness, Insomnia - decrease with continued use.

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3
Q

Asenapine (Saphris)

A

Consider whether a REGULAR INJECTION may suit you

A) Anti-Psychotic

B)

  1. Schizophrenia
  2. Bipolar disorder

C)
5-10 mg BD (TWICE daily)

D)
(good S/E profile)
1. BP (minimal)
2. Lipids
3. Full BLOOD count
4. WEIGHT (minimal)
5. Blood GLUCOSE (minimal)
6. LIVER function tests (avoid use in impairment)
NO renal

E)
Labels: 1, 16
#Put the wafer UNDER YOUR TONGUE and allow it to dissolve; do not crush, chew or swallow it.
#Don’t EAT or DRINK for 10 mins after taking it
#Take the wafers AFTER your other MEDICINES
#The inside of your mouth may feel TINGLY or NUMB for about an HOUR after taking the wafer (oral hypoaesthesia)

#Avoid taking ILLICIT substances (increases risk of relapse)
**DR - RASH (hypersensitivity after the 1st dose)
S/E
*OTHER (insomnia, akathisia, hyper-salivation)

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4
Q

Chlorpromazine (Largactil)

A

A) Anti-Psychotic

B)

  1. Acute and Chronic PSYCHOSES
  2. Short-term management of ANXIETY, AGITATION or DISTURBED BEHAVIOUR in non-psychotic disorders
  3. Intractable HICCIP
  4. NAUSEA and VOMITING in terminal illness

C)
25-100 mg TDS - QID
MAX 600 mg daily

D)
1. RESPIRATORY depression**
2. ANTICHOLINERGIC effects**
3. SEIZURE risk**
4. EPSE (lower, but high with higher doses)**
5. PHOTOSENSITIVITY**
6. Weight (++)
7. Blood GLUCOSE (++)
8. BP (+++ orthostatic hypotension)
9. Full BLOOD count
10. Lipids
11. LIVER (avoid use)
NO renal
E)
Labels: 1, 8, 9 (long-term regular), 16
#Avoid excessive skin exposure to SUNLIGHT and sunlamps; wear protective clothing
#Consider whether a REGULAR INJECTION may suit you
#Avoid taking ILLICIT substances (increases risk of relapse)
S/E
*ANTICHOL (dry mouth, constipation, blurred vision, difficulty urinating)
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5
Q

Clozapine (Clopine)

A

A) Anti-Psychotic

B)
1. SCHIZOPHRENIA in people unresponsive, or intolerant of other antipsychotics

C)
12.5 - 900 mg daily

D)

  1. Complete BLOOD Count (agranulocytosis)***
  2. CARDIAC function - MYOCARDITIS development (cardiotoxicity)***
  3. Serum CLOZAPINE concentration***
  4. SEIZURE risk***
  5. ANTICHOLINERGIC effects***
  6. WITHDRAWAL (cholinergic rebound symptoms)
  7. Blood GLUCOSE (+++)
  8. WEIGHT (+++)
  9. BP (+++ orthostatic hypotension)
  10. Lipids
  11. TOBACCO smoking habit change
  12. CAFFEINE intake habit change
  13. Renal (contraindicated)
  14. Hepatic (contraindicated)

E)
Labels: 1, 9, 12, 16
#You will need REGULAR BLOOD tests
#Takes 1-2 weeks before noticing a difference; doctor may want to TRIAL for 2-3 months
#Your Clozapine dose may need changing if you vary your CAFFEINE intake (tea, coffee, cola) or if you start or stop smoking TOBACCO; tell your DR** if these habits change

#Take REGULARLY to prevent risk of RELAPSE
#Avoid taking ILLICIT substances (increases risk of relapse)

**DR - (hepatic damage) yellow skin or eyes, dark urine, loss of appetite.
S/E
*ANTICHOL (constipation, urinary incontinence)
*CNS (drowsiness, headaches)
*MOTOR (hypersalivation)

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6
Q

Haloperidol (Serenace)

A

A) Anti-Psychotic

B)

  1. Acute and Chronic PSYCHOSES
  2. Acute MANIA
  3. TOURETTE syndrome and other CHOREAS
  4. HALLUCINATIONS (adjunct) due to EtOH withdrawal
  5. Intractable NAUSEA and VOMITING (associated with cancer tx)
  6. Short-term management of Acute, Severe ANXIETY, AGITATION or DISTURBED BEHAVIOUR in non-psychotic disorders

C)
Oral 0.5 - 15 mg daily (in 2 or 3 doses)
or 5-10 mg every 2 hrs as needed (acute psychoses and mania)

D)
1. QT interval (prolonged) ***
2. EPSE ***
3. Weight (minimal)
4. Blood Glucose (minimal)
5. BP (minimal)
6. Lipids
7. Full Blood Count
8. Liver (minimal)
NO renal nor hepatic adjustments

E)
Labels: 1, 16
#Avoid taking ILLICIT substances (increases risk of relapse)
S/E
*Insomnia, Headaches, Constipation, Blurred vision, Dry mouth and Excessive Perspiration

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7
Q

Lurasidone (Latuda)

A

A) Anti-Psychotic

B)
1. Schizophrenia

C)
40-160 mg ONCE daily

D)

  1. QT interval (little effect)
  2. Drug INTERACTIONS (CYP3A4 substrate)
  3. MOOD changes (suicidality emergence)**
  4. EPSE (++) - akathisia and parkinsonism are common
  5. Weight (minimal)
  6. Blood Glucose (minimal)
  7. BP (minimal)
  8. Lipids
  9. Full Blood Count
  10. HEPATIC (reduce dose)
  11. RENAL (reduce dose - increases serum creatinine)

E)
Labels: 1, 16, 18, B (with FOOD)
#Take with FOOD to increase absorption
#Avoid GRAPEFRUIT juice
#Takes 1-2 weeks to notice a difference. Dr may want to trial it for 2-3 months
#Avoid getting overheated or DEHYDRATED - do not over-exercise, drink plenty of water, avoid hot environments (Anticholinergic)
**DR - unusually thirsty, hungry, weak, tired or confused, or need to urinate more frequently (blood glucose)
S/E
*CNS (sedation, insomnia, nausea)
*MOTOR (akathisia, parkinsonism)

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8
Q

Olanzapine (Zyprexa)

A

A) Anti-psychotic

B)

  1. Schizophrenia
  2. Bipolar disorder (with lithium or valproate)

C)
5-20 mg daily

D)
1. Blood GLUCOSE (+++)
2. Weight (+++)
3. Anticholinergic (++)
4. BP (minimal)
5. Lipids (dyslipidaemia)
6. TOBACCO use (increases clearance of olanzapine)
7. CARDIOVASCULAR effects (hypotension)
NO renal or hepatic

E)
Labels: 1, 8, 16
#Takes 1-2 weeks before noticing a difference. DR may want to trial it for 2-3 months
#Wafer: Place in mouth; allow to disperse in saliva, then swallow
#Tell your doctor if you start or stop SMOKING tobacco, as your dose may need to be changed
S/E
*hyperglycaemia, peripheral oedema, constipation, dry mouth and weight gain

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9
Q

Paliperidone (Invega)

A

A) Anti-psychotic

B)

  1. Schizophrenia
  2. Acute exacerbations of SCHIZOAFFECTIVE disorder

C)
3-12 mg ONCE daily

D)

  1. Weight (++)
  2. Blood Glucose (minimal)
  3. BP (++) (orthostatic hypotension)
  4. Lipids
  5. Full blood count
  6. RENAL (reduce dose)
  7. Liver function tests
  8. Prolactin (+++)

E)
Labels: 1, 16, A (swallow whole - CR)
#Take the tablets the SAME WAY each day (always with food or always on an empty stomach)
S/E
*Palpitations, Nausea, Dry Mouth, Constipation and Weight gain

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10
Q

Pericyazine (Neulactil)

A

A) Anti-Psychotic

B)
1. Acute and Chronic PSYCHOSES

C)
2.5 - 75 mg daily (in 2 doses)

D)

E)
Labels: 1, 9 (chronic psychoses), 16

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11
Q

Quetiapine (Seroquel)

A

A) Anti-psychotic

B)

  1. Schizophrenia
  2. Bipolar disorder
  3. Treatment-resistant Major Depression (adjunct)
  4. Generalised Anxiety Disorder

C)
25-400 mg BD
Max 800 mg daily

D)
1. THYROID function**
2. Weight (++)
3. Blood Glucose (++)
4. BP (orthostatic hypotension ++)
5. Lipids (dyslipidaemia)
6. Full Blood Count
7. LIVER function (elevated aminotransferases)
NO renal

E)
Labels: 1, 9, 12+, 16+, 18, A (swallow CR whole)
#Takes 1-2 weeks to notice a difference. DR may want to trial for 2-3 months
S/E:
*Constipation, Nausea, Dry mouth and Weight gain

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12
Q

Risperidone (Risperdal)

A

A) Anti-psychotic

B)

  1. Schizophrenia and related PSYCHOSES
  2. Bipolar Disorder
  3. Behaviour disturbances (dementia)
  4. Conduct and Disruptive behaviour disorders (mental retardation)
  5. Behaviour disorders (autism)

C)
0.25 mg BD to 6 mg daily

D)
1. Weight (++)
2. Blood Glucose (minimal)
3. BP (orthostatic hypotension ++)
4. Prolactin (+++)
5. Sexual/ejaculatory problems
6. Lipids
7. Full Blood Count
8. Liver function (reduce dose)
NO renal

E)
Labels: 1, 16, A* (liquid)
#Takes 1-2 weeks to notice a difference. DR may want to trial for 2-3 months
S/E
*Insomnia, Akathisia, Headaches, Nausea, Constipation, Restlessness and Weight gain

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13
Q

Trifluoperazine (Stelazine)

A

A) Phenothiazine Anti-psychotic

B)

  1. Acute and Chronic Psychoses
  2. Short-term management of ANXIETY, AGITATION or DISTURBED BEHAVIOUR in non-psychotic disorders

C)
2mg BD - 15mg daily

D)

  1. Weight
  2. Blood Glucose
  3. BP
  4. Lipids
  5. Full Blood Count
  6. Liver function

E)
Labels: 1, 8, 9 (chronic) and 16
#Takes 1-2 weeks to notice a difference. DR may want to trial for 2-3 months
S/E:
*Dry mouth, Constipation, NASAL CONGESTION, headache, BLURRED VISION and nausea - decrease or disappear with continued use

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14
Q

Ziprasidone (Zeldox)

A

A) Antipsychotic

B)

  1. Schizophrenia and related psychoses
  2. Acute Mania

C)
20-80 mg BD (TWICE daily)

D)

  1. QT interval (may prolong)*
  2. Hypersensitivity **
  3. Weight (minimal)
  4. Blood glucose (minimal)
  5. BP (minimal)
  6. Lipids
  7. Full Blood Count
  8. Liver function

E)
Labels: 1, 12, 16, 18, A*, B (capsules WITH FOOD)
#Takes 1-2 weeks to notice a difference. DR may want to trial for 2-3 months
**DR - (hypersensitivity) rash
**DR - (QT prolongation) sudden palpitations, fainting or seizures
S/E
*Hypersalivation, Weakness, Blurred vision, Constipation, Dry mouth and Nausea

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15
Q

Zuclopenthixol (Clopixol)

A

A) Anti-Psychotic

B)

  1. Acute and Chronic PSYCHOSES
  2. Acute Mania

C)
10-75 mg daily

D)

  1. Weight
  2. Blood Glucose
  3. BP
  4. Lipids
  5. Full Blood Count
  6. Liver Function

E)
Labels: 1, 8, 16
**DR - sore mouth, gums or throat; fever or cold symptoms
S/E
*Dry Mouth, Blurred vision, Constipation, Sweating, Nausea and Difficulty urinating

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Chapter 18 Psychotropic (8 decks)

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