CNS - Psychosis And Schizophrenia Flashcards

1
Q

What are positive symptoms in psychosis?

A

Adding to your body

  • Delusions
  • Hallucinations
  • Disorganisation
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2
Q

What are Negative symptoms in Psychosis?

A

Withdrawn effect

  • Social withdrawal
  • Neglect
  • Poor hygiene
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3
Q

1st Generation phenothiazines split into how many groups?

A

3

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4
Q

Which drugs are in Group 1 - 1st gen Phenothiazines?

A
  • PROMAZINES

Chloropromazine,
levomepromazine and promazine

Pro means FIRST IN LINE

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5
Q

Most sedative phenothizines?

A

-promazines

Chlorpromazine
Levomepromazine
Promazine

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6
Q

Which drugs are in Group 2 - 1st gen Phenothiazines?

A

-azine

Pericyazine

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7
Q

Which 1st gen phenothiazine has the least extra pyramidal side effects?

A

Pericyazine

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8
Q

Which drugs are in Group 3 - 1st gen Phenothiazines?

A

Fluphenazine
Prochloroperazine
Trifluoperazine

(Moderate sedation)

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9
Q

Which 1st gen pheniothiazine has the highest extra pyramidal side effects?

A

Group 3
Fluphenazine
Prochloroperazine
Trifluoperazine

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10
Q

Why should you not give Parkinson’s patients antipsychotics?

A

Extrapyramidal side effects!

Further reduces dopamine levels

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11
Q

What are the 1st gen other drugs?

A

Butyrophenines
(Haloperidol + Benperidol)

Thioxanthenes
(Flupentixol & Zuclopenfgixol)

Others
(Pimozide & Sulpride)

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12
Q

Which 1st gen have highest extra pyramidal side effects?

A

Haloperidol & Benperidol

Similar to group 3

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13
Q

Pimozide & sulpride sedation?

A

Reduced sedation

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14
Q

2nd Gen Antipsychotics?

A

Amisulpride
Ariprazole
Clozapine
OLANZAPINE
Quetiapine
Risperidone

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15
Q

If pt has prolactinaemia which antipsychotic is best to be given?

A

Ariprazole

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16
Q

Which antipsychotics cause sexual dysfunction?

17
Q

Which antipsychotic cause QT prolongation?

A

Pimozide and Haloperidol

18
Q

Which Antipsychotic causes hypotension?

A

Clozapine and Quetiapine

19
Q

Which antipsychotic causes Hyperglycaemia?

A

Clozapine
i
Risperidone
OLANZAPINE
Quetiapine

CIROQ

20
Q

Which antipsychotic causes weight gain?

A

Clozapine
Olanzapine
Weight gain

COW

21
Q

Which antipsychotic cause neuroleptic malignant syndrome?

22
Q

How to treat neuroleptic malignant syndrome?

A

Stop antipsychotic treatment ->
Treat with Bromocriptine (ergot derived)
Resolves in around 5-7days

23
Q

Antipsychotic monitoring?

A

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)

24
Q

What determines if it is resistant schizophrenia?

A

2 or more antipsychotics should have been used for 6-8 weeks

***One must have be 2nd gen

25
What drug treats resistant schizophrenia?
Clozapine
26
If more than 2 Clozapine doses are missed what should you do?
Needs to be reinitiated by specialist
27
Clozapine monitoring what?
Leukocytes and differential blood counts
28
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
29
Clozapine side effects
Myocarditis and Cardiomyopathy Agranulocytosis and Neutropenia Gastrointestinal Disturbances ***MAG***
30
Pt on clozapine has myocarditis and cardiomyopathy, what should happen?
Report and refer to stop due to tachycardia
31
Why is it important to monitor leukocytes and differential blood counts in clozapine?
To avoid Neutropenia or Agranulocytosis from occurring
32
Pt has GI disturbances on clozapine, what should happen?
Report & refer to stop Constipation can cause intestinal block Reduces intestinal peristalsis rate
33
Myocarditis is most common in what patient group taking clozapine?
Children