IM Depot Antipsychotics

Question 1

Fluphenazine

Answer 1

Q2w
10mg=12.5mgIM
**DOES NOT NEED ORAL OVERLAP
Oil based, need to Ztrack

Question 2

Haloperidol

Answer 2

Q4w
Load: 20 times the oral dose
Maint: 10 times the oral dose (if only use maintenance may need oral overlap)
Oil based Ztrack

Question 3

Invega Sustenna

Answer 3

Loading dose, then booster (both must be given in deltoid), then Q4w (beginning 5 weeks after loading injection)
234mg day 1
156mg day 8 (usually maintenance dose)
117mg given 5 weeks after first injection
NO NÉED FOR ORAL OVERLAP (if you use the loading dose)
May require dose adj in renal impairment

Question 4

Invega Trinza

Answer 4

ONLY use if pt has been stable on invega sus
Dosed Q12w
15 secs of wrist snapping to shake (&must be given w/I 5 mins)
Given in deltoid
Not recommend in CrCl

Question 5

Zyprexa Relprevv

Answer 5

Q2-4w (based on needed dose)
Requires registration
PDSS (post delirium sedation syndrome)
Must be administered by and under supervision of a clinician 
Very expensive, no pt assistance program needed
ORAL          IM
10qd         210 Q2w
15qd         405 Q4w
20qd        300 Q2w

IF PT IS ON HIGHER THAN 20 mg, can do oral and IM therapy
Cannot be given with lorazepam or any benzos!!

Question 6

Ability Maintena

Answer 6

400 IM given q4w
MUST overlap with oral aripiprazole for 14 days after first injection
Must reconstitute
2nd or 3rd missed dose? Administer ASAP if more than 5 weeks, restart oral med
DOSE ADJ for P450 interactions

Question 7

Aristida

Answer 7

Prodrug of arip
Overlap with arip for 3 weeks
Deltoid for 441 mgs
10mg=441 q4w IM
15mg=662mg 
20mg= 882mg (can be given q6 weeks if pt responds)
Pre filled syringes

Question 8

Risperdal Consta

Answer 8

25mg Qw
1-2mg=25mgIM
2-4=37.5mgIM
5-8mg=50mgIM
MUST supplement IM with oral Risperidone for the 1st few weeks (usually til 3rd injection)
Fridge and reconstituted before injecting