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Psychiatry > Antipsychotics Jeopardy > Flashcards

Antipsychotics Jeopardy Flashcards

1
Q

Not only was this drug the first antipsychotic, it was the first psychotropic medication of any kind.

A

Chlorpromazine (Thorazine)

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2
Q

Typical antipsychotics are divided into these two categories which also correlates to their D2 receptor’s binding affinity

A

High potency and low potency

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3
Q

This typical antipsychotic is available PO, IM, and IV, is commonly used to treat agitated patients in hospitals/ER’s, and can be used to treat Tourette’s syndrome.

A

Haloperidol (Haldol)

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4
Q

Three anticholinergic meds commonly used to counter extrapyramidal side-effects (EPS) are: trihexyphenidyl (Artane), benztropine (Cogentin), & this medication

A

Diphenhydramine (Benadryl)

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5
Q

When used in their long-acting injectable form, these 2 FGA’s are given IM every 2-4 weeks to treat pts w/ chronic schizophrenia.

A
  • Haloperidol (Haldol)

- Fluphenazine (Prolixin)

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6
Q

This type of typical antipsychotic is anti-cholinergic, anti-histaminic, & an α1 adrenergic antagonist.

A

Low potency antipsychotic

- Chlorpromazine (thorazine)

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7
Q

While prochlorperazine (Compazine) is a D2 blocker, it is more commonly used for this than its antipsychotic properties.

A

Antiemetic properties

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8
Q

This antipsychotic can also be used to treat intractable hiccups.

A

Chlorpromazine (Thorazine)

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9
Q

This typical antipsychotic has the greatest risk of any antipsychotic for dose dependent QTc prolongation, torsades de pointes, and cardiotoxicity

A

Thioridazine (Mellaril)

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10
Q

Even though its the most efficacious antipsychotic, its side effect profile prevents this drug from consideration for first line use.

A

Clozapine (Clozaril)

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11
Q

This atypical antipsychotic is used to treat psychosis in Lewy Body Dementia & Parkinson’s Disease due to its low likelihood of EPS.

A

Quetiapine (Seroquel)

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12
Q

These 2 atypicals are available in a long acting injectable form and have the highest risk among atypicals of causing prolactin elevation.

A
  • Risperidone (Risperdal)

- Paliperidone (Invega)

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13
Q

These two atypicals are most likely to cause side effects of significant sedation and the metabolic syndrome.

A
  • Olanzapine (Zyprexa)

- Clozapine (Clozaril)

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14
Q

Of all the SGA’s, this med has the highest risk of causing

QTc prolongation.

A

Ziprasidone (Geodon)

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15
Q

This SGA is a partial dopamine agonist & commonly has the side effect akathisia.

A

Aripiprazole (Abilify)

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16
Q

This atypical is FDA approved for adjunct treatment of MDD.

A

Aripiprazole (Abilify)

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17
Q

Due to the risk of seizure induction, slow dose titration must be done for this atypical antipsychotic.

A

Clozapine (Clozaril)

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18
Q

Lurasidone (Latuda), asenapine (Saphris) & these two SGA’s are the most metabolically “neutral”.

A
  • Ziprasidone (Geodon)

- Aripiprazole (Abilify)

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19
Q

More common with typical antipsychotics, this side effect is characterized by repetitive, involuntary, purposeless
movements.

A

Tardive dyskinesia

20
Q

For a pt taking Clozapine (Clozaril), this is done when the WBC is <2,000 or the ANC is <1,000.

A 
Abrupt stop
(abrupt stop → rebound psychosis; do gradual taper when possible)
21
Q

Due to the risk of metabolic syndrome, pts on atypicals should have their weight, waist circumference, and these 2 labs monitored regularly.

A
  • Glucose

- Lipids

22
Q

The picture shows a pt experiencing this EPS side

effect. (Neck tilted towards shoulder)

A

Dystonia

23
Q

Clozapine (Clozaril), quetiapine (Seroquel), iloperidone (Fanapt), risperidone (Risperdal) paliperidone (Invega)

may all cause dose dependent orthostatic hypotension due to this.

A

α1 adrenergic antagonism

- Undesirable in elderly pts & pts at risk for falls

24
Q

There is a blackbox warning for the use of antipsychotics in elderly dementia patients due to increased risk of this.

A

Sudden death (CV cause)

25
Q

The antipsychotic side effect seen in this pt is this (eyes looking upward and towards midline, asymmetrically)

A

Oculogyric crisis

26
Q

What is the MoA behind gynecomastia in pts taking D2-receptor blockers?

A

Hyperprolactinemia

27
Q

This atypical may cause dry mouth due to its anticholinergic properties, but ironically it may also cause excess salivation.

A

Clozapine (Clozaril)

28
Q

SGA’s work primary by blocking these 2 receptors.

A

D2 receptor

5HT2A receptor

29
Q

The positive sx of schizophrenia are due to hyperactivity of what dopamine tract?

A

Mesolimbic pathway

30
Q

Excess blockade of this dopamine tract may cause infertility, galactorrhea, and osteopenia.

A

Tubuloinfundibular pathway

31
Q

When switching to aripiprazole (Abilify) from a different antipsychotic, before the other antipsychotic has washed out, the aripiprazole (abilify)—at least in theory— initially does this at the D2 receptors.

A

Act as a dopamine agonist
- When switching to abilify, need to switch slowly or
have a washout period

32
Q

The % of D2 occupancy necessary for the antipsychotic effect is this.

A

60%

33
Q

This % of occupancy at D2 is believed to be associated with elevated prolactin and/or EPS.

A

80%

34
Q

While NMS is uncommon to rare (incident rate 0.02-3%), its

cause is this.

A

Dopamine antagonism

35
Q

Hypoactivity of this dopamine tract is believed to be a/w the development of negative sx.

A

Mesocortical pathway

36
Q

The SGA with the unique MoA of partial dopamine agonism is this.

A

Aripiprazole (Abilify)

37
Q

Prochlorperazine (Compazine) Metoclopramide (Reglan)
Droperidol (Inapsine) Promethazine (Phenergan)

This antiemetic medication(s) is/are a D2 blocker(s) and may cause EPS or tardive dyskinesia (TD).

A

All

38
Q

About 75% of pts with schizophrenia do this unhealthy activity which also induces increased metabolism of antipsychotic meds.

A

Cigarette smoking

39
Q

While not diagnostic for NMS
(it may be nl if there is not clearly well developed rigidity), this lab’s degree of abnormality correlates with the disease severity and prognosis.

A

Creatine kinase

40
Q

Antipsychotics approved for the treatment of bipolar depression are olanzapine/fluoxetine (Symbyax), lurasidone (Latuda), and this.

A

Quetiapine (Seroquel)

41
Q

This atypical has a significant risk of causing hyperprolactinemia, is the active metabolite of risperidone (Risperdal), and needs to be
taken with food.

A

Paliperidone (Invega)

42
Q

The 4 SGA’s that are available in long acting injectable preparations are: risperidone (Risperidal Consta), olanzapine (Zyprexa Relprevv), and these two meds.

A
  • Paliperidone (Invega Sustenna)

- Aripiprazole (Abilify Maintena)

43
Q

Antipsychotic side effects of sedation and weight gain are likely due to antagonist activity at this receptor.

A

Histamine (H1)

44
Q

Young or Elderly
Males or Females

This demographic is at the greatest risk for dystonia from antipsychotics.

A

Young males

45
Q

While muscular rigidity, hyperthermia, and autonomic instability are all common sx of NMS, most often this symptom presents first.

A

Mental status changes

Psychiatry (16 decks)

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