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PRP2 > CNS - Psychosis And Schizophrenia > Flashcards

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Withdrawn effect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?

A

All

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?

A

All

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
Q

What drug treats resistant schizophrenia?

A

Clozapine

26
Q

If more than 2 Clozapine doses are missed what should you do?

A

Needs to be reinitiated by specialist

27
Q

Clozapine monitoring what?

A

Leukocytes and differential blood counts

28
Q

Clozapine monitoring regime?

A

Weekly up to week 18

Fortnightly 18wks till end of year

Monthly after a year

Continue through med & 1 month after last dose

29
Q

Clozapine side effects

A

Myocarditis and Cardiomyopathy
Agranulocytosis and Neutropenia
Gastrointestinal Disturbances

MAG

30
Q

Pt on clozapine has myocarditis and cardiomyopathy, what should happen?

A

Report and refer to stop due to tachycardia

31
Q

Why is it important to monitor leukocytes and differential blood counts in clozapine?

A

To avoid Neutropenia or Agranulocytosis from occurring

32
Q

Pt has GI disturbances on clozapine, what should happen?

A

Report & refer to stop

Constipation can cause intestinal block

Reduces intestinal peristalsis rate

33
Q

Myocarditis is most common in what patient group taking clozapine?

A

Children

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