CNS - Psychosis And Schizophrenia Flashcards
What are positive symptoms in psychosis?
Adding to your body
- Delusions
- Hallucinations
- Disorganisation
What are Negative symptoms in Psychosis?
Withdrawn effect
- Social withdrawal
- Neglect
- Poor hygiene
1st Generation phenothiazines split into how many groups?
3
Which drugs are in Group 1 - 1st gen Phenothiazines?
- PROMAZINES
Chloropromazine,
levomepromazine and promazine
Pro means FIRST IN LINE
Most sedative phenothizines?
-promazines
Chlorpromazine
Levomepromazine
Promazine
Which drugs are in Group 2 - 1st gen Phenothiazines?
-azine
Pericyazine
Which 1st gen phenothiazine has the least extra pyramidal side effects?
Pericyazine
Which drugs are in Group 3 - 1st gen Phenothiazines?
Fluphenazine
Prochloroperazine
Trifluoperazine
(Moderate sedation)
Which 1st gen pheniothiazine has the highest extra pyramidal side effects?
Group 3
Fluphenazine
Prochloroperazine
Trifluoperazine
Why should you not give Parkinson’s patients antipsychotics?
Extrapyramidal side effects!
Further reduces dopamine levels
What are the 1st gen other drugs?
Butyrophenines
(Haloperidol + Benperidol)
Thioxanthenes
(Flupentixol & Zuclopenfgixol)
Others
(Pimozide & Sulpride)
Which 1st gen have highest extra pyramidal side effects?
Haloperidol & Benperidol
Similar to group 3
Pimozide & sulpride sedation?
Reduced sedation
2nd Gen Antipsychotics?
Amisulpride
Ariprazole
Clozapine
OLANZAPINE
Quetiapine
Risperidone
If pt has prolactinaemia which antipsychotic is best to be given?
Ariprazole
Which antipsychotics cause sexual dysfunction?
All
Which antipsychotic cause QT prolongation?
Pimozide and Haloperidol
Which Antipsychotic causes hypotension?
Clozapine and Quetiapine
Which antipsychotic causes Hyperglycaemia?
Clozapine
i
Risperidone
OLANZAPINE
Quetiapine
CIROQ
Which antipsychotic causes weight gain?
Clozapine
Olanzapine
Weight gain
COW
Which antipsychotic cause neuroleptic malignant syndrome?
All
How to treat neuroleptic malignant syndrome?
Stop antipsychotic treatment ->
Treat with Bromocriptine (ergot derived)
Resolves in around 5-7days
Antipsychotic monitoring?
Weight
(Weekly for first 6wks, at 12wks, at 1yr then yearly)
Fasting Blood glucose + lipid conc
(12wks then 1 year then yearly)
ECG (before initiation)
BP (12wks then 1 year then yearly)
Fbc, urea and electrolytes, LFT
(Start then yearly)
What determines if it is resistant schizophrenia?
2 or more antipsychotics should have been used for 6-8 weeks
***One must have be 2nd gen
What drug treats resistant schizophrenia?
Clozapine
If more than 2 Clozapine doses are missed what should you do?
Needs to be reinitiated by specialist
Clozapine monitoring what?
Leukocytes and differential blood counts
Clozapine monitoring regime?
Weekly up to week 18
Fortnightly 18wks till end of year
Monthly after a year
Continue through med & 1 month after last dose
Clozapine side effects
Myocarditis and Cardiomyopathy
Agranulocytosis and Neutropenia
Gastrointestinal Disturbances
MAG
Pt on clozapine has myocarditis and cardiomyopathy, what should happen?
Report and refer to stop due to tachycardia
Why is it important to monitor leukocytes and differential blood counts in clozapine?
To avoid Neutropenia or Agranulocytosis from occurring
Pt has GI disturbances on clozapine, what should happen?
Report & refer to stop
Constipation can cause intestinal block
Reduces intestinal peristalsis rate
Myocarditis is most common in what patient group taking clozapine?
Children
