exam 3 patty's drugs

Question 1

in general, how long does it take for antipsychotic drugs to change symptoms

Answer 1

1-2 weeks

Question 2

during the stabilization period, how long should you wait before considering a change in prescription

Answer 2

6-12 weeks

Question 3

for max absorption, ziprasidone and lurasidone should be given with

Answer 3

food

Question 4

which drug should be taken with a high fat meal of 500 calories

Answer 4

ziprasidone

Question 5

350 callories should be eaten with which med

Answer 5

lurasidone

Question 6

for what medical reasons might someone stop taking meds

Answer 6

• neuroplectic malignant syndrome
• agranulocytosis
• drug reaction with eosniophilia
• systemic symptoms
• tartive dyskinesia

Question 7

how should these drugs be stopped

Answer 7

gradually lowering the dose over time

-this diminishes the chances of withdrawal symptoms

Question 8

how to treat parkinsonism

Answer 8

decrease dosage (increasing dopamine activity)
adding anticholinergic drug (decreasing acetylcholine)
(benztropine or trihexyphenidyl)

Question 9

dystonic reactions usually start with what

Answer 9

oculogyric crisis
followed by torticollis (neck muscles pull head to side)
retrocolis (head pulled back)

Question 10

how to treat dystonic reactinos

Answer 10

admin benztropine or diphenhydramine IM or IV

Question 11

risperdone (risperdal) class

Answer 11

Atypical antipsychotic

Question 12

risperdone moa

Answer 12

antagonist for D2 and 5-Ht2 and H1

Question 13

indications for risperdone

Answer 13

• treatment of schizo
• short term treatment of acute manic or mixed episodes associated with bipolar 1
• irritability with autistic disorder

Question 14

routes for risperdone

Answer 14

tablets and liquid

Question 15

SE f risperdone

Answer 15

insomnia, agitation, anxiety, extrapyrimidal symptoms, headache, rhinitis, somnolence, dizziness, headache, constipation, nausea, dyspepsia, vomiting, abd pain, hypersalvation, tachy, orthostatic hypotension, fever, chest pain, coughing, photosensitive, wt gain

Question 16

boxed warning for risperdone

Answer 16

increased mortality in elderly pts with dementia related psychosis

Question 17

black box warning for risperdone

Answer 17

development of neuroleptic maligant syndrome
-observe for signs of tartive dyskinesia
-use caution in pts with cardiovascular disease
-can cause electrocardiographic changes
avoid during pregnancy
-avoid for hepatic or renal imparements

Question 18

clozapine class

Answer 18

atypical

Question 19

clozapine action

Answer 19

clozapine D1 and D2 blockade

produces fewer XPE than standard antipsychotics with lower risk for tartive dyskinesia

Question 20

indications for clozapine

Answer 20

severely ill pts with schizo and have not responded to standard drugs
reduction in risk of recurrent suicidal behavior

Question 21

clozapine SE

Answer 21

dry outh, heartburn, blurred vision, hematologic changes, seizures, tremmor, akathisia

Question 22

boxed warning for clozapine

Answer 22

agranulocytosis (<500) most often within 4-10 weeks

-weekly counts needed and 4 weeks after discontinuation

Question 23

how to treat akathisia

Answer 23

reduce dose

give a beta blocker

Question 24

benztropine class

Answer 24

antiparkinsonism agent

Question 25

benztropine moa

Answer 25

``` blocks cholinergic (acetylcholine) activity restors the balance of acetylcholine and dopamine in the basal ganglia ```

Question 26

indications for benztropine

Answer 26

reduce EPS - dystonia - pseudoparkinsonism - akethisia (not tartives) - most effective with acute dystonia

Question 27

benztropine SE

Answer 27

-dry mouth -blurred vision -tachy -flushing or temp -decrease in sweating -muscle weakness -pee issues -hallucinations -memory loss -

Question 28

warning for benztropine

Answer 28

avoid using while preggo caution for heatstroke dont use in glaucoma or doudenal issues may agrivate tartives

Question 29

why does hyperprolactinemia occur

Answer 29

dopamine is brocked and cant repress prolactin and thus gynecomastia and glactorrhea may happen

Question 30

what drugs are associated with hyperprolactinemia

Answer 30

haloperidol and risperidone | -should be reduced or changed

Question 31

wt gain is seen with what two most

Answer 31

olanzapine and clozapine

Question 32

new onset dm is seen with which gen

Answer 32

second gen

Question 33

cardiac arrhythmias seen how and with what

Answer 33

prolonged QT with ziprasidone (geodon)

Question 34

which drug does DRESS have a 10% death rate with

Answer 34

ziprasidone (geodon)

Question 35

primary s/s of neuroleptic maligant syndrome

Answer 35

``` onset of 2 weeks -mental status changes -muscle rigidtiy -autonomic changes (temp, tachy, BP, STOP MEDS ```

Question 36

how to treat NMS

Answer 36

``` dopamine agonist (bromocriptine) muscle relaxants ```

Question 37

s/s of cholinergic rebound

Answer 37

- vomiting - sweatting - altered dreams

Question 38

s.s of anticholenergic crisis

Answer 38

- fever - parched mouth - burning thirst - hot dry skin - decreased salvation - widely dilated eyes - anxiety - agitation - delirium - hyperactivity usually only last 3 days-self limiting physostigmine is inhibitor to antichoinesterace