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PCC 3 > exam 3 patty's drugs > Flashcards

exam 3 patty's drugs Flashcards

1
Q

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

A

1-2 weeks

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2
Q

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

A

6-12 weeks

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3
Q

for max absorption, ziprasidone and lurasidone should be given with

A

food

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4
Q

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

A

ziprasidone

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5
Q

350 callories should be eaten with which med

A

lurasidone

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6
Q

for what medical reasons might someone stop taking meds

A
  • neuroplectic malignant syndrome
  • agranulocytosis
  • drug reaction with eosniophilia
  • systemic symptoms
  • tartive dyskinesia
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7
Q

how should these drugs be stopped

A

gradually lowering the dose over time

-this diminishes the chances of withdrawal symptoms

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8
Q

how to treat parkinsonism

A

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

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9
Q

dystonic reactions usually start with what

A

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

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10
Q

how to treat dystonic reactinos

A

admin benztropine or diphenhydramine IM or IV

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11
Q

risperdone (risperdal) class

A

Atypical antipsychotic

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12
Q

risperdone moa

A

antagonist for D2 and 5-Ht2 and H1

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13
Q

indications for risperdone

A
  • treatment of schizo
  • short term treatment of acute manic or mixed episodes associated with bipolar 1
  • irritability with autistic disorder
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14
Q

routes for risperdone

A

tablets and liquid

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15
Q

SE f risperdone

A

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

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16
Q

boxed warning for risperdone

A

increased mortality in elderly pts with dementia related psychosis

17
Q

black box warning for risperdone

A

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

18
Q

clozapine class

A

atypical

19
Q

clozapine action

A

clozapine D1 and D2 blockade

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

20
Q

indications for clozapine

A

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

21
Q

clozapine SE

A

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

22
Q

boxed warning for clozapine

A

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

-weekly counts needed and 4 weeks after discontinuation

23
Q

how to treat akathisia

A

reduce dose

give a beta blocker

24
Q

benztropine class

A

antiparkinsonism agent

25
Q

benztropine moa

A 
blocks cholinergic (acetylcholine) activity
restors the balance of acetylcholine and dopamine in the basal ganglia
26
Q

indications for benztropine

A

reduce EPS

  • dystonia
  • pseudoparkinsonism
  • akethisia (not tartives)
  • most effective with acute dystonia
27
Q

benztropine SE

A

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

28
Q

warning for benztropine

A

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

29
Q

why does hyperprolactinemia occur

A

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

30
Q

what drugs are associated with hyperprolactinemia

A

haloperidol and risperidone

-should be reduced or changed

31
Q

wt gain is seen with what two most

A

olanzapine and clozapine

32
Q

new onset dm is seen with which gen

A

second gen

33
Q

cardiac arrhythmias seen how and with what

A

prolonged QT with ziprasidone (geodon)

34
Q

which drug does DRESS have a 10% death rate with

A

ziprasidone (geodon)

35
Q

primary s/s of neuroleptic maligant syndrome

A 
onset of 2 weeks
-mental status changes
-muscle rigidtiy
-autonomic changes (temp, tachy, BP, 
STOP MEDS
36
Q

how to treat NMS

A 
dopamine agonist (bromocriptine)
muscle relaxants
37
Q

s/s of cholinergic rebound

A
  • vomiting
  • sweatting
  • altered dreams
38
Q

s.s of anticholenergic crisis

A
  • 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

PCC 3 (3 decks)

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