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NAPLEX > Chapter 64: Schizophrenia/Psychosis > Flashcards

Chapter 64: Schizophrenia/Psychosis Flashcards

1
Q

Dystonias

A

Prolonged contraction of muscles during drug initiation, including painful muscle contraction; life-threatening if airway is compromised.

Diphenhydramine and benztropine can be used for prophylaxis or treatment

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2
Q

Akathisia

A

Restlessness with anxiety and an inability to remain still;

Treated with benzodiazepines or propranolol

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3
Q

Parkinsonism

A

Looks similar to Parkison disease, with tremors, abnormal gait, and bradykinesia.

Treat with anticholinergics or propranolol if tremor is the main symptom

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4
Q

Tardive dyskinesia

A

Abnormal facial movements, primarily in the tongue or mouth; TD can be irreversible.

Must stop drug and replace with an SGA with low EPS risk (quetiapine, clozapine)

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5
Q

Dyskinesias

A

Abnormal movements, more common with dopamine replacement for Parkinson disease

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6
Q

Medications That Can Cause Psychotic Symptoms

A 
Anticholinergic 
Dextromethorphan
Dopamine or dopamine agonists (requip, mirapex, sinemet)
Interferons
Stimulants (e.g amphetamines) 
Systemic steroids
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7
Q

Illicit Drugs That Can Cause Psychosis

A 
Bath salts (synthetic cathinones, MDPV)
Cannabis
Cocaine 
Lysergic acid diethylamide (LSD)
Meth, Ice, Crystal
Phencyclidine (PCP)
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8
Q

Thioridazine Boxed Warnings

A

QT prolongation

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9
Q

1st Gen Antipsychotics Boxed Warning

A

Elderly patients with demetia-related psychosis have increased risk of death from antipsychotics

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10
Q

Haloperidol Class

A

butyrophenone

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11
Q

Haloperidol Decanoate

A

IM Q Monthly

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12
Q

1st gen Antipsychotics Warnings

A
  • QT prolongation (thioridazine, haloperidol, chlopromazine), orthostasis/falls
  • Anticholinergic effects
  • CNS depression
  • Extrapyramidal Symptoms
  • Hyperprolactinemia
  • Neuroleptic malignant syndrome
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13
Q

1st Gen Antipsychotics SE

A
  • Sedation
  • Dizziness
  • Anticholinergic Effects
  • EPS
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14
Q

Aripiprazole SE

A 
Abilify 
Akathisia 
Activating
Lower risk of weight gain
Some QT prolongation 
EPS (in children)
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15
Q

Abilify Long-Acting

A

Maintena: IM Q month
Aristada: IM q4-8 weeks

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16
Q

Clozapine Boxed Warnings

A

Neutropenia/Agranulocytosis
Myocarditis and cardiomyopathy
Seizures

17
Q

Clozapine SE

A 
Agranulocytosis
Seizures
Constipation
Metabolic Syndrome (Weight gain, increased BG, increased lipids)
Hypersalivation
18
Q

Clozapine REMS

A 
To start TX ANC must be >1,500
Check ANC weekly for 6 months;
Then every 2 weeks for 6 months;
Then Monthly
STOP if ANC <1,000
19
Q

Lurasidone SE

A 
Latuda
Somnolence
EPS (dystonias)
Nausea
Almost weight, lipid and BG neutral
20
Q

Olanzapine SE

A

Zyprexa
Somnolence
Metabolic Syndrome (increased weight, BG and Lipids)

21
Q

Zyprexa Relprev

A

Lasts 2-4 weeks

Boxed warnings: must be monitored for 3 hours after injection (REMS program)

22
Q

Paliperidone SE

A

Invega
Increased prolactin
EPS (especially at higher doses)
Metabolic syndrome (increased weight, bg, lipids)

23
Q

Invega sustenna

A

IM Q monthly

24
Q

Invega Trinza

A

IM Q3 months

Start only after receiving sustenna for 4 months

25
Q

Quetiapine SE

A
  • Somnolence
  • Metabolic Syndrome

Low EPS (often used for psychosis is Parkinson disease)

26
Q

Quetiapine Notes

A

Take XR ar night without food or with a light meal (<=300kcal)

27
Q

Risperidone SE

A
  • Increased prolactin
  • EPS especially in higher doses
  • Metabolic Syndrome
28
Q

Risperidal Consta

A

IM q2 weeks

29
Q

Ziprasidone CI

A

Geodon

CI with QT prolongation; Do not use with QT risk

30
Q

Ziprasidone notes

A

Take with food

Also comes IM

31
Q

Saphris

A

Asenaphine
SL tab
Can cause tongue numbness

32
Q

QT prolonging drugs

A
  • Ziprasidone
  • Haloperidol
  • Thioridazine
  • Chlorpromazine
33
Q

Drugs with High Risk of EPS

A
  • FGAs
  • Risperidone
  • Paliperidone

*quetiapine preferred

34
Q

Drugs that Worsen Metabolic Risk

A
  • Olanzapine

- Quetiapine

35
Q

Drugs with Lower Metabolic Risk

A
  • Aripiprazole
  • Ziprasidone
  • Lurasidone
  • Asenapine

NAPLEX (45 decks)

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