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Pharm Test 3 > Antipsychotics/Mood Stabilizers > Flashcards

Antipsychotics/Mood Stabilizers Flashcards

1
Q

What FDA approved anti-bipolar drugs can be used as adjunct therapy?

A

ziprasidone
quetiapine
quietiapine XR

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2
Q

What bipolar drugs can also be used for treatment of depression?

A

seroquel XR

one other…

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3
Q

33 y/o with one episode of mania and no other PMH (no depression). What drug would you treat her with?

A

lithium

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4
Q

What is the DOC for mania associated with bipolar disorder?

A

lithium

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5
Q

What three tests do you need to do prior to starting lithium?

A

pregnancy test
serum creatinine
TSH

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6
Q

What is the average dose of lithium?

A

300 mg bid

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7
Q

What is a common AE of lithium that many complain of?

A

GI irritation including diarrhea

-have them drink adequate fluid, leave at current dose to see if symptoms resolve

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8
Q

What would you treat someone with who has had multiple manic/depressive (5/7 a year) episodes with an ETOH abuse problem?

A

depakote would be a good choice given his h/o ETOH abuse (he is also a rapid cycler)

start at 250 bid and titrate to 500

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9
Q

You’ve started a pt on depakote and you see a rise in their liver enzymes….what do you do?

A

nothing yet

-don’t change the dose until the LFT levels have at least tripled in value from their baseline

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10
Q

What is trichotillomania?

A

pulling out hair

can treat with antipsychotics

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11
Q

What is the MOA of typical antipsychotics?

A

D2 dopamine receptor antagonists

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12
Q

D2 dopatine receptor antagonists have a high risk of _________________

A

extrapyramidal side effects

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13
Q

What are the D2 dopamine receptor antagonists (high potency)?

A

fluohenazine
haloperidol
pimozide

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14
Q

What are the low potency typical antipsychotics?

A

chlorpromaine

thioridazine

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15
Q

What are the AE of low potency typical antipsychotics

A

sedation

hypotension

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16
Q

What are the D2 dopamine receptor antagonists?

A 
fluhenazine
halperidol*
pimozide
chlorpromaine*
thioridazine 
*most commonly used
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17
Q

What is the MOA of the atypical antipsychotics?

A

serotonin-dopamine 2 antagonists DSAs

they block both receptors

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18
Q

What kind of drug is risperidone?

A

atypical D2 receptor antagonists

acts as typical at high doses

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19
Q

Risperidone is the most likely atypical to induce ________________

A

hyperprolactinemia

*know this

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20
Q

What are the common AE of risperidone?

A

weight gain
sedation
(dose dependent)

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21
Q

Risperidone acts as a typical antipsychotic at doses greater than ___________

A

6mg

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22
Q

Those on olanzapine or seroquel may see rises in what lab values?

A

hypertriglyceridemia
hypercholesterolemia
hyperglycemia

23
Q

____________ may cause transaminitis

A

olanzapine

seroquel

24
Q

What drug is most likely to cause orthostatic hypotension

A

seroquel

25
Q

What EKG change may you see with ziprasidone?

A

QT prolongation

26
Q

Is ziprasidone associated with weight gain?

A

nope

27
Q

What is the MOA of aripiprazole?

A

its a D2 partial agonists

28
Q

What drug interacts with CYP2D6 and 3A4?

A

aripiprazole

29
Q

What drug is associated with agranulocytosis?

A

clozapine

*last resort drug

30
Q

How often do you draw blood when taking clozapine?

A

every 2 weeks for 6 months

31
Q

What dont you want to combine with clozapine?

A

lithium

32
Q

What antipsychotic drug has the highest incidence of sedation, weight gain and transaminitis?

A

clozapine

33
Q

How do you administer iloperidone?

A

titate over 4 days to avoid orthostatic hypotension

34
Q

What two receptors does iloperidone interact with?

A

3A4 (ketoconazole)

2D6 (fluozetine)

35
Q

Does iloperidone cause EKG changes?

A

yes

QT prolongation

36
Q

In what form does asenapine come in?

A

sublingual (no food or liquid for 10 minutes)

37
Q

What does asenapine inhibit?

A

CYP1A2

anything to do with the liver

38
Q

How must you administer latuda?

A

with food >350 kcal

39
Q

Most antipsychotics interact with what receptor?

A

CYP 3A4

40
Q

What is neuroleptic malignant syndrome?

A

severe muscle rigidity, fever, AMS, autonomic instability, elevated WBC, CPK and LFTs-potentially fatal

41
Q

What are the extrapyramidal side effects?

A

acute dystonia
parkinson syndrome
akathisia

42
Q

What is tardive dyskinesia?

A

involuntary muscle movements

a common AE of antipsychotics

43
Q

What are some agents used to combat extrapyramidal side effects?

A

anticholinergics
dopamine facilitators
beta blockers

44
Q

What baseline blood work should you get before starting an antipsychotic?

A

lipids
glucose
LFT
CBC

45
Q

What antipsychotic drug would you treat a person with that had a poor lipid panel?

A

risperidone
ziprasidone
aripiprazole

46
Q

What is a person experiencing when they say they feel “uncomfortable” in their skin while taking an antipsychotic?

A

akathisia

*lower the dose or give a beta blocker or anticholinergic

47
Q

In anxiety disorders you often give what kinds of drugs along with anxiolytics?

A

SSRIs

SNRIs

48
Q

With what can you treat insomnias and parasomnias?

A

anxiolytics

49
Q

MOA of buspirone

A

serotonin agonists

5HT1A

50
Q

What is a con of buspirone?

A

will not reduce anxiety in pts that are used to taking BZDs because there is no sedation effect to buspirone

51
Q

What disorders do you treat with benzos?

A

insomnia
parasomnias
anxiety

52
Q

What kind of drug is commonly used for someone going through ETOH w/d?

A

benzodiazapines

53
Q

What is a major con of using benzos?

A

dependence

Pharm Test 3 (5 decks)

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