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PHRM 845 > Antipsychotics Ott > Flashcards

Antipsychotics Ott Flashcards

1
Q

onset of schizophrenia in males and females

A

males - late teens early 20s
women - late 20s early 30s

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2
Q

smoking is associated with induction of ____ because of ____

A

1A2, hydrocarbons

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3
Q

what to do if pt smokes and takes a 1A2 substrate

A

increase the dose

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4
Q

most commonly used typical antipsychotic

A

haloperidol, can be used PRN

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5
Q

which antipsychotics are partial agonists

A

aripipraozole
bexiprazole
cariprazine

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6
Q

partial agonists are associated with increased what

A

akathasia, low weight gain

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7
Q

partial agonists are approved for ajunct treatment in what?

A

depression, box warning suicide

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8
Q

aripiprazole is a ____ substrate

A

2D6 and 3A4

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9
Q

bexiprazole is a ____ substrate

A

2D6 and 3A4

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10
Q

cariprazine is a ____ substrate

A

3A4

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11
Q

which drug has a patch and sublingual formulation?

A

asenapine

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12
Q

asenapine is a substrate of ___

A

1A2

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13
Q

asenapine has ____

A

QTC prolongation

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14
Q

clozapine is a _____substrate

A

1A2

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15
Q

boxed warnings for clozapine

A

neutropenia, orthostasis, bradycardia, syncope, seizures, myocarditis, cardiomyopathy

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16
Q

clozapine side effects

A

sedation, constipation, weight gain, hypersalivation, dry mouth, GI hypomotility,

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17
Q

drugs with QTC prolongation

A

asenapine, clozapine, quetiapine, iloperidone, ziprasidone, paliperidone

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18
Q

olanzapine is a ____ substrate

A

1A2

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19
Q

olanzapine side effects

A

weight gain and sedation
DRESS warning

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20
Q

quetiapine is a _____substrate

A

3A4

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21
Q

quetiapine side effects

A

weight gain and sedation
suicide ideation

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22
Q

asenapine patch should be applied every

A

24 hours, rotate sites

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23
Q

clozapine REMS

A

absolute neutrophil count
monitoring weekly x 6 months
biweekly x 6 months
then every 4 weeks

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24
Q

what drug is the combo opioid antagonist

A

olanzapine/samidorphan
mu opioid activity

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25
Q

iloperidone risks

A

orthostasis and syncope

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26
Q

iloperidone is a _____ substrate

A

2D6

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27
Q

lurasidone is a ____ substrate

A

3A4

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28
Q

lurasidone risks

A

akathasia, suicidal

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29
Q

which should be taken with food

A

lurasidone and ziprasidone

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30
Q

ziprasidone is a _____ substrate

A

3A4 and aldehyde oxidase

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31
Q

risperidone is a ______ substrate

A

2D6 (3a4 minor)

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32
Q

risperidone side effects

A

EPS, hyperprolactinemia, weight gain, sedation, orthostatis

33
Q

paliperidone side effects

A

similar to risperidone

34
Q

which drug renally eliminated

A

paliperidone

35
Q

lumateperone (Capylta) is a ____ substrate

A

3A4

36
Q

lumateperone side effects

A

low risk for weight gain, akathesia, EPS

37
Q

pimavanserin use

A

hallucinations in Parkinsons disease
inverse agonist and antagonist and serotoni 5HT2A

38
Q

pimavanserin is a ____ substrate

A

3A4

39
Q

which drug must be Z tracked, is long acting for 4 weeks

A

haloperiodol

40
Q

Risperdal consta requirements

A

must supplement with oral risperidone for first 4 weeks of treatment

41
Q

what is Perseris and where does it go

A

risperidone injection
abdominal subq injection

42
Q

what is Rykindo and dosing

A

risperidone injection
every 2 week injection
oral dose overlap is only 7 days

43
Q

what is Uzedy and dosing

A

risperidone injection
abdominal or upper arm subq
given once every month or 2 months

44
Q

what is Invega Sustenna and dosing
given in _____

A

paliperidone
loading then booster then every 4 weeks
loading and booster given in deltoid

45
Q

does Invega need oral overlap

A

no, if we have loading

46
Q

Invega sustenna has ____ elimination

A

renal

47
Q

Invega Trinza can be given when

A

if at least 4 stable invega sustenna doses

48
Q

Invega Trinza given in ____

A

deltoid

49
Q

Invega Trinza not recomended in _____

A

CrCl < 50 mL/min

50
Q

what is Invega Trinza

A

paliperidone q3 months

51
Q

what is Invega Hafyera

A

paliperidone q6 months

52
Q

when can we give Invega Hafyera

A

sustenna - 4 months OR
trinza - one 3 month dose

53
Q

Invega Hafyera is a ____ injection

A

gluteal

54
Q

Zyprexa Relprevv risk

A

PDSS - post dose delirium sedation syndrome

55
Q

Zyprexa Relprevv is what drug

A

olanzapine

56
Q

abilify maintena and asimtufii requirement

A

overlap with oral aripiprazole for 14 days after first injection

57
Q

where to administer abilify maintena

A

deltoid, gluteal

58
Q

when do we need to adjust dose for Abilify Maintena?

A

if we are taking 2D6 or 3A4 inhibitors or 3A4 inducers for more than 14 days with it

59
Q

Abilify Asimtufii dosing and site

A

every 2 months, gluteal

60
Q

Aristada requirement

A

prodrug so overlap with 3 weeks of oral

61
Q

Aristada initio does not need what

A

overlap of oral for 3 weeks

62
Q

when to avoid Aristada Initio

A

poor 2D6 metabolizers or with strong 3A4 or 2D6 inhibitors

63
Q

immediate release antipsychotic injections

A

haloperidol, chlorpromazine, fluphenazine
Lozapine for inhalation

64
Q

what can we not give together with olanzapine IM immediate release

A

benzodiazepines IR, respiratory depression

65
Q

treatment for acute dystonia

A

anticholinergics IM (benztropine, diphenhydramine)

66
Q

treatment for Parkinsons induced symptoms

A

anticholinergics PO (benztropine, diphenhydramine, trihexphyenidyl)

67
Q

treatment for akathisia

A

beta blocker - propranolol
benzodiazepine - lorazepam

68
Q

treatment for tardive dyskinesias

A

VMAT inhibitors

69
Q

VMAT inhibitors

A

valbenazine
deutetrabenazine

70
Q

VMAT inhibitors cause

A

QTC prolongation

71
Q

valbenazine is a substrate for ___

A

2D6/3A4

72
Q

deutetrabenazine is a substrate for ___

A

2D6

73
Q

neuroleptic malignant syndrome is what

A

life threatening

74
Q

symptoms of NMS

A

hyperpyrezia, tachycardia, labile bP
muscle rigidity, elevated CK

75
Q

is future antipsychotic use contraindicated in NMS

A

no

76
Q

drugs with highest risk of metabolic issues

A

clozapine, olanzapine

77
Q

metabolic issues

A

HTN, hyperglycemia, hyperlipidemia

78
Q

what should we monitor with metabolic

A

family hx
BMI
waist
BP
glucose / a1c
lipids fasting

79
Q
A

PHRM 845 (38 decks)

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