Central Nervous System - Psychosis + Schizoprenia

Question 1

what are the +ve symptoms in psychosis + schizophrenia

Answer 1

delusions, hallucinations, disorganisations

Question 2

what are the -ve symptoms in psychosis + schizophrenia

Answer 2

social withdrawal, neglect, poor hygiene

Question 3

What are the 1st gen antipyschotics?

Answer 3

phenothiazines
thioxanthenes
butyprohenones

Question 4

What are the 2nd gen antipyschotics?

Answer 4

ORCQA2
olanzapine
risperidone
clozapine
quetiapine
Aripiprazole
Amisulpride

Question 5

how many groups are they of phenothiazines

Answer 5

3 groups

Question 6

what are the drugs in 1st gen phenzothiazines group 1

Answer 6

chlorpromazine, levomepromazine, promazine

Question 7

what are the drugs in 1st gen phenzothiazines group 2

Answer 7

pericyazine

Question 8

what are the drugs in 1st gen phenzothiazines group 3

Answer 8

-fluphenazine, prochlorperazine, trifluoperazine

Question 9

chlorpromazine, levomepromazine, promazine

what is the s/e of Group 1 phenzothiazines

Answer 9

most sedation
moderate antimuscarinic + EPSEs

Question 10

pericyazine

what is the s/e of Group 2 phenzothiazines

Answer 10

-moderate sedation
-least EPSEs

Question 11

-fluphenazine, prochlorperazine, trifluoperazine

what is the s/e of Group 3 phenzothiazines

Answer 11

-moderate sedation
-high EPSEs

Question 12

What are the drugs in 1st gen butyrophenones

Answer 12

benperidol + haloperidol

Question 13

benperidol + haloperidol

what are the s/e of 1st gen butyrophenones

Answer 13

-moderate sedation
-high EPSEs

Question 14

what are the drugs in 1st gen thioxanthies

Answer 14

-flupentixol
-zuclopentini**xol **

Question 15

flupentixol, zuclopentinixol

what are the s/e of 1st gen thioxanthies

Answer 15

• moderate sedation, antimuscarinic effects + EPSEs

Question 16

what are the other drugs in 1st gen?

Answer 16

pimozide
sulpride

Question 17

what are the s/e of pimozide + sulpride

Answer 17

-reduced sedation, antimuscarinic effects +EPSEs

Question 18

which antipsychotics cause extrapyramidal s/e?

Answer 18

group 3 phenothiazines (perazines) + butyropheriones peridol

Question 19

which antipsychotics cause hyperprolactinaemia?

Answer 19

all but least in aripiprazole

Question 20

which antipyschotics cause sexual dysfunction?

Answer 20

ALL

Question 21

which antipyschotics cause cardiovascular s/e - QT prolongation?

Answer 21

pimozide + haloperidol

Question 22

which antipyschotics cause hypertension?

Answer 22

clozapine + quetiapine

Question 23

which antipyschotics cause hyperglycaemia

Answer 23

CORQ
clozapine
olanzapine
risperidone
quetiapine

Question 24

which antipyschotics cause weight gain

Answer 24

olanzapine + clozapine

Question 25

How often should weight be monitored in antipyschotics?

Answer 25

weekly for 6WK * 12WK for 1YR * yearly

Question 26

what is tx of neuroleptic maligant syndrome?

Answer 26

- tx should be stopped before tx neuroleptic malignant syndrome - tx with **bromocriptine** resolve in 5-7DY

Question 27

How often should fasting blood glucose/HbA1c + blood lipid conc be monitored?

Answer 27

start at 12WK for 1YR * yearly

Question 28

how often should blood pressure be monitored in antipyschotics?

Answer 28

start at 12WK for 1YR * yearly

Question 29

how often should ECG be monitored in antipyschotics?

Answer 29

before initation only

Question 30

how often should FBC, U+Es + LFT be monitored in antipyschotics?

Answer 30

start then yearly

Question 31

what is clozapine used in?

Answer 31

resistant schizophrenia

Question 32

when should clozapine be used?

Answer 32

only when** 2+ antipyschotics** including **1x 2nd gen** has been used for** 6-8WK each**

Question 32

if 2+ doses missed in clozapine what happens?

Answer 32

only reinitated by specialist

Question 33

what is monitored in clozapine and how often?

Answer 33

leuocyte + differential blood counts - weekly for 18WK * fornightly for 1YR * monthly

Question 34

what are the s/e of clozapine?

Answer 34

-myocarditis + cardiomyopathy -agranulocytes + neutropenia -GI disturbances

Question 35

what to do if pt is on clozapine and develops myocarditis + cardiomyopathy?

Answer 35

report and STOP if **tachycardia**

Question 36

what to do if pt is on clozapine and develops agranulocytes + neutropenia?

Answer 36

monitor leuocycte and differential blood counts

Question 37

what to do if pt is on clozapine and develops GI disturbances?

Answer 37

report on constipation and STOP if **intestinal block**