atypicals Flashcards
clozapine side effects
agranulocytosis, tachycardia, hypersalivation, myocarditis, seizures
(clozaril)
risperidone side effects
orthostatic hypotension, increased prolactin, reflex tachycardia
(risperdal, risperdal consta)
quetiapine
sedation, ortho hypotension
seroquel
olanzapine
weight gain, dyslipidemia, sedation
zyprexa
ziprasidone
qtc prolongation, take with food
geodon
aripiprazole
partial d2 agonism
more activating than sedating
less weight gain
(abilify, abilify maintena)
paliperidone
from risperidone
invega, invega susteina
lurasidone
for bipolar depression, take with food
latuda
long-acting (1st and 2nd gen) 4
haloperidol+fluphenazine (deconate)
abilify maintena-aripripazole
risperol consta-riseridone
invega sustaina-paliperidone
more sedating 2
clozapine + quetiapine
more orthostatic hypotension 2
risperidone + quetiapine
can help with tourettes
risperidone
other ttx by atypicals besides psychosis
ttx resistant depression, ocd (with ssri)
drug classes for mood stabilization (3)
atypicals, lithium, anticonvulsants
role of mood stabilizers (3)
- acute mania, maintenance,
- augmentation of antidepressants for major depressive disorder, potentiation of antipsychotics in schizo.,
- treat aggression and impulsivity, enhance abstience in alcoholism
lithium uses (4)
acute mania, prophylaxis of manic and depressive episodes of bipolar + schizoaffective
cyclothymic, unipolar depression
lithium lab tests
lithium, creatinine, thyroid, cbc, chem, pregnancy, ecg
lithium side effects
gi disturbances, ecg changes, sedation, weight gain, benign leukocytosis
tremors, convulsion, mental status change, delurium, coma, death
ebstein’s anomoly
factors increasing lithium levels
nsaids, diuretics (HCTZ), aspirin
dehydration
impaired renal function
sweating -salt loss, salt deprivation
valproic acid moa
block na channels
increase GABA concn
monitor cbc, lft
valproic acid use
acute mania, rapid cycling, mania w/mixed features
lamotrigine moa
block na channels that modulate glutamate + aspartate
lamotrigine use
bipolar DEPRESSION
lamotrigine side effects
sjs at beginning (so low dose and gradually higher)
headache, dizziness, sedation, ataxia
valproate lamotrigine relationship
valproate increases lamotrigine
lamotrigine decreases valproate
lithium vs carbamazepine
lithium-benign leukocytosis (helpful in clozapine)
vs
carbamazepine-benign leukopenia + aplasic anemia
carbamazepine
block Na channels
carbamazepine use
acute mania + rapid cycling but not depressive
carbamazepine side effects
sedation, confusion, ataxia, gi, benign leukopenia, aplasic anemia, hepatitis, nystagmus, motor restlessness, tremor, twitching
siadh, hyponatremia, sjs, rash
carbamazepine monitoring
works 5-7d
monitor levels induction, 3w,6w,9w autometab by p450
cbc, lft,