Exam 1 study guide Flashcards
First approved treatments SPECIFICALLY for TD
Valbenazine (Ingrezza)
Deutetrabenazine (Austedo)
Think about “benazine” being similar to treatment with benztropine
How to treat TD
Lower med dose, d/c, switch to clozapine lowest TD risk
*Benztropine(cogentin)
Clonazepam
Amantidine
Tetrabenazine
Tx akathisia (restlessness)
Beta blocker (propranolol)
Low dose mirtazapine based on its antagonist activity at the serotonin 5-HT(2A)/5-HT(2C) receptors
Tx pseudo parkinsonism
Benztropine/cogentin
Baseline exams FGA
EKG (QTc prolongation)
Lipids
LFTs
AIMS
EPS
dystonia, akathisia, pseudo-parkinsonism
d/t alpha 1 blockade & D2 blockade in nigrostriatal pathway
NMS symptoms
FALTERED
F- fever
A- autonomic dysfunction
L- leukocytosis
T- tremor
E- elevated CK
R- rigidity
E- excessive sweating
D- delirium
NMS tx
d/c med
fluids
IV benzos
cooling blankets
sodium dantrolene, bromocriptine, amantadine
ECT
why not prescribe drugs with FGA to prevent EPS
high anticholinergic SE risk
SGA use
acute mania, bipolar, adjunct in unipolar depression
metabolic syndrome
HTN ( >135/85), elevated triglycerides, truncal obesity, low HDL
SE of SGA
Baseline exams SGA
lipids
Glucose
A1C
Bp, weight, waist circumference, BMI
how often to do labs if established on SGA already
yearly (lipids, A1c, glucose)
Most common SGA meds to cause weight gain
clozapine, quetiapine, olanzapine
“pine”
SGA meds least associated with weight gain
aripiprazole, ziprazidone, lurasidone (& FGA haliperidol)
“done” and “ole”
SGA with strongest H1 antagonism
quetiapine
leads to sedation and weight gain
what SGA for acute agitation IM
olanzapine (Zyprexa)
works in 15 min
post injection syndrome
concern with olanzapine LA injection called relprevv
monitor x3 hours s/p injection d/t risk delirium & sedation syndrome
what SGA has the greatest elevated prolactin risk
risperidone (Risperdal)
Weight neutral SGAs
ziprasidone (Geodon)
aripiprazole (Abilify)
SGA approved for bipolar depression
lurasidone (Latuda)
med for refractory schizophrenia (Tx resistant)
clozapine
SGA that lowers SI
clozapine
SGA to most likely cause weight gain & hypersalivation/sialorrhea
clozapine