Medications

Question 1

Risperdal
Class:
Indications:
Caution:

Answer 1

Class: Atypical antipsychotic

Indications: schizophrenia, bipolar

Caution: renal, hepatic impairment, DM, drug induced leukopenia, Parkinson’s

Question 2

Depakote
Class:
Indications:
Caution:

Answer 2

(valproate)
Class: anticonvulsant

Indications: bipolar, seizures

Caution: hepatic impairment, reproductive females->teratogenic

Question 3

Invega Sustenna
Class:
Indications:
Caution:

Answer 3

(paliperidone palmitate)
Class: 2nd generation antipsychotic

Indications: Schizophrenia, schizoaffective

Caution: long QT syndrome, bradycardia, recent MI, CHF, leukopenia, hypo-K+/Mg+

Question 4

Acamprosate
Class:
Indications:
Caution:

Answer 4

Class: sulfuric acid

Indications: Alcohol dependence

Caution: CrCl<30, suicide risk, depression

Question 5

Benztropine
Class:
Indications:
Caution:

Answer 5

Class: anticholinergic

Indications: dystonia, Parkinson disease

Caution: glaucoma, tardive dyskinesia, ileus, BPH, cardiovascular dz

Question 6

Lexapro
Class:
Indications:
Caution:

Answer 6

Class: SSRI

Indications: MDD, GAD, OCD

Caution: QTc, hepatic impairment, ventricular arrhythmias, recent MI, CHF, hypomania/hx of mania

Question 7

What should be monitored with atypical antipsychotics? Which carry the highest risk

Answer 7

Metabolic syndrome-> weight gain, dyslipidemia, DM
Monitor weight, BP, lipid profile, fasting glucose, waist circumference
Highest risk-> olanzapine, clozapine
Lowest risk-> aripiprazole, ziprasidone,m lurasidone, pimavanserin

Question 8

Olanzapine
Class:
Indications:
Caution:

Answer 8

Class: atypical antipsychotic

Indications: schizophrenia, bipolar 1, agitation, depression

Caution: metabolic syndrome, orthostatic hypotension, extrapyramidal syndrome, increased prolactin, personality disorder, drowsiness

Question 9

Clozapine
Class:
Caution:

Answer 9

Class: atypical antipsychotic

Caution: agranulocytosis0> monitor absolute neutrophil count

Question 10

EPS

Answer 10

Extrapyramidal symptoms

Parkinsonian syndrome (tremor, slow movement, impaired speech or muscle stiffness)

Acute dystonias (muscle(s) contract uncontrollably causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures)

Akathisia (subjective feeling of inner restlessness accompanied by mental distress and an inability to sit still)

Question 11

Tardive dyskinesias

Answer 11

late onset choreiform and athetoid movements of the truck, extremities, or mouth (stiff, jerky movements of your face and body which can’t be controlled)

Question 12

NMS

Describe and Tx

Answer 12

Neuroleptic Malignant Syndrome
Can occur at any time w/ antipsychotic agent

Movement disorder (muscle rigidity, dystonia, agitation) + autonomic sx (high fever, sweating, tachycardia, HTN)

Tx: supportive (hydration and cooling) +/- dantrolene and/or bromocriptine