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LAST PHARM TEST > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

___ given to pts with mania

A

Chlorpromazine - induces state of indifference in pts

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2
Q

antipsychotics theory

A

DA receptor overstimulation

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3
Q

do antipsychotic meds take away dlusions?

A

no still on the back burner but helps them work thorugh other sx.. normal thoughts however also blocked

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4
Q

side effect of antipsychoitcs

A

dysphoria: state where they have no feelings or emotions at all

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5
Q

6 antipsychotic inidications

A 
Schizophrenia 
Bipolar disorder 
Acute psychosis - mania 
major depression with pshyosis 
severe behavioral problems  
Tourette syndrome - haloperidol
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6
Q

first gen antipsychotics aka

A

dopamine antagonists, typical antipsychotics, neuroleptics

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7
Q

5 first gen antipsychotics

A 
haloperidol 
fluphenazine 
perphenazine 
thioridazine 
chlorpromazine

Hint: haloperidol + “azine”

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8
Q

MOA first gen antipsychotics

A 
D2 receptor antagonist  
5HT2c receptor antagonist - weight gain 
Alpha 1 antagonist - sedation 
H1 antagonist - sedation, weight gain 
M1 antagonist - anticholinergic effects
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9
Q

3 effects of antipsychotics

A

relief of positive sx (hallucinations etc)
induction of EPS : akathisia, dystonia, etc
Increased prolactin levels (will mess with DA)

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10
Q

indications aripiprazole

A 
schizo, 
bipolar manic / mixed (mono or add to lithium or valproate)  
add on major depressive 
irritability with autisim for kids
acute tx agitation
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11
Q

indications asenapine

A

acute schizo

bipolar mixed/ manic

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12
Q

indications clozapine

A

Tx resistant schizo

reduce SI in younger pts / adults

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13
Q

indications iloperidone

A

adult acute schizo

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14
Q

indications olanzapine

A

schizo bipolar disorder
bipolar disorder
tx resistant depression
agitation with schiszo and bipolar mania

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15
Q

indications paliperidone

A

schizo

schizoaffective disorder

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16
Q

indications quetiapine

A

schizo
bipolar disorder depression, maintainince, acute mainia
add on major depressive disorder

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17
Q

Risperidone

A

schizo
bipolar disorder
irritable with autism (5-16)

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18
Q

ziprasidone

A

schizo

bipolar disorder manic, mixed, depression

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19
Q

Antipsych ADRS with anticholinergic effects

A

Clozapine

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20
Q

Antipsych ADRS with dyslpidemia

A

olanzapine and clozapine

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21
Q

risperidone has ___

A

extrapyramidal sx

22
Q

clozapine has postural__

A

hypotension ADR

23
Q

ziprasidone can produce

A

long QT probs

24
Q

clozapine can induce a __

A

seizure

25
Q

risperidone can lead to ___ dysfunction

A

sexual

26
Q

2 antiphyscs that can lead to DM 2 or worsen

A

clozapine and olanzapine

27
Q

weight gain seen with…

A

clozapine, olanzapine

and also quetiapine and risperidone

28
Q

___ first drug to tx tardive dyskinesia

A

valbenazine

29
Q

MOA valbenazine

A

VMAT2 inhibitor.. turns down signal path and lowers DA release

30
Q

ADR of valbenazine

A

somnolence, balance disorder, fall, HA, akathisisa, arthralgia

31
Q

black box on all psychotics

A

dementia related psychosis - higher mortality elderly

infection, CV with atypical antipsychotics

32
Q

clozapine monitor

A

baseline WBC then weekly then 6 mo.. due to agranulocytosis

watch for: myocarditis, orthostatsis, bradycardia, lower seizure threshold

33
Q

clozapine drug int

A

cigarette smoke..why? tobacco 1A2 inducer, and clozapine is a substrate.. may change the drugs metabolism

KEY: clozapine caution with smokers

34
Q

if former smoker on clozapine decreases or quits smoking need to …

A

lower the dose with other 1A2 inhibitors - ciprofloxacin

35
Q

clozapine avoid using with ___

A

strong 3A4 inhibitors

36
Q

7 day antipsych goal

A

decrease agitiation, hostility etc
normalize sleep and eat
titrate meds close or effective dose

37
Q

2 to 3 wk goals

A

increase socialization, self care, mood

get to target dose and maintain

38
Q

ilioperidone p450

A

2D6 and 3A4 substrate

39
Q

paliperidone MOA and indication

A

schizo

DA 5ht2 H1 alpha receptor blocker

40
Q

asenapine ADR

A

constipation, agitation, N/v somnolence, insomnia psychosis

41
Q

brexipiprazole increased..

A

mortality old ppl with psychosis tardive dyskinesia, NMS

42
Q

brexipiprazole ADR

A

high sugars, fats, weight gain, blood dyscrasia, restlessness

43
Q

dystonia 3 meds

A

benztropine mesylate
diphenhydramine (Benadryl)
trihexyphenidyl

44
Q

5 akathisia meds

A 
clonazepam 
lorazepam 
pramipexole 
propranolol 
ropinirole
45
Q

neuroleptic malignant syndrome 4 options

A

dantrolene sodium
anticholinergics: benztropine, trihexyphenidyl
dopamine agonists: amantadine, bromocriptine, ropinirole

46
Q

parkinsonism 4 options

A

amantadine
anticholinergic
pramipexole
ropinirole

47
Q

neuroleptic induced catatonia 3

A

anticholinergics, bromocriptine and other DA agonists

48
Q

lithum is first line for__

A

manic episodes of bipolar disorder

maintenance tx for bipolar disorder

49
Q

major warnings lithum 2

A

teratogenic

renal toxicity

50
Q

lithum toxic over 1.5 mEq/L sx…

A

V/D, lack coorditiation

tinnitus, dilute urine, giddy, blurr vision

51
Q

lithium can mask

A

BRUGADA SYNDROME

52
Q

when lithium CI? 3

A

renal cv dz
dehydration or na depletion
pt on diuretics

LAST PHARM TEST (4 decks)

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