Chap. 9 - SZO, drugs and side effects

Question 1

High potency drugs have _____ risk of EPS but _____ risk of sedation and anticholinergic symptoms

Answer 1

greater risk of EPS, less risk of sedation

Question 2

Low potency drugs have _____ of EPS but _____ risk of sedation and anticholinergic symptoms

Answer 2

less risk of EPS, greater risk of sedation

Question 3

Caffeine and nicotine will enhance or diminish the efficacy of the typicals?

Answer 3

Diminish

Question 4

Treatment of EPS: 4 drug classes

Answer 4

Anticholinergics
Antihistamines
Dopamine agonists
Benzos

Question 5

Symptoms of TD are most prominent, and noticed soonest, in the _____ area

Answer 5

Perioral (lip smacking, tongue protrusion)

Question 6

AIMS screening should be every __ - __ months

Answer 6

3 - 6 months

Question 7

Your first intervention, should you notice symptoms of TD, is to…

Answer 7

Reduce the dose or change to an atypical

Question 8

A big number on the AIMS scale (which runs 0-40) is good or bad?

Answer 8

It’s bad. 10 items ranked 0 (no problem) to 4 (severe problem), plus questions about dentition.

Question 9

NMS confirmed by three elevated labs:

Answer 9

CPK
WBC
LFT

Question 10

Early signs of NMS (3)

Answer 10

Altered sensorium
Hyperthermia
Hyper-reflexia

Question 11

Immediate treatment for NMS: Name 2 drugs, and their class

Answer 11

Parlodel (bromocriptine) - direct dopamine agonist

Dantrium (dantrolene) - muscle relaxant

Question 12

Late stage NMS - Hypertension or hypotension?
Tachycardia or bradycardia?
Tachypnea or bradypnea?

Answer 12

Hypotension
Tachycardia
Tachypnea

Question 13

Akatihisia

Answer 13

An objective motor restlessness, or an subjective sense of restlessness with no objective finding

Question 14

Akinesia

Answer 14

Absence of movement, or difficulty initiating motion, or a subjective feeling of lack of motivation to move

Question 15

Dystonia

Answer 15

Muscle spasm, esp. back and neck muscles

Question 16

Pseudo-parkinson’s

Answer 16

Shuffling gait, pill rolling, tremors, rigidity, masked expression

Question 17

Tardive dyskinesia

Answer 17

Involuntary abnormal muscle movement of the mouth, tongue, face, and jaw that may progress to limbs. Can be irreversible.

Question 18

SUD comorbid rate with SZO

Answer 18

20-40%

Question 19

Nicotine dependence comorbid rate with SZO

Answer 19

80-90%

Question 20

Suicide rates in SZO

Answer 20

10% complete

20-40% attempt

Question 21

Four scales used to measure psychotic sx

Answer 21

PANSS (Positive and Negative Symptom Scale)
BPRS (Brief Psychotic Rating Scale)
SAPS (Scale for Assessment of Positive Symptoms)
SANS (Scale for Assessment of Negative Symptoms)