Meds

Question 1

meds for NCD (4)

Answer 1

• cholinesterase inhibitors
• NMDA receptor agonists
• antipsychotics
• benzodiazepines

Question 2

antipsychotics for NCD (3)

Answer 2

• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Haloperidol (Haldol)

Question 3

examples of benzodiazepines (2)

Answer 3

• Clonazepam (Klonipin)

- Lorazepam (Ativan)

Question 4

FGA example

Answer 4

Haloperidol (Haldol)

Question 5

SGA examples (5)

Answer 5

• Aripiprazole (Abilify)
• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Clozapine (Clozaril)

Question 6

Clozapine

Answer 6

• trade: Clozaril
• first effective antipsychotic (SGA) with low EPS
• reserved for patients who have failed standard therapies because of side effects

Question 7

Clozapine side effects (2)

Answer 7

• agranulocytosis

- risk for myocarditis

Question 8

antipsychotics indication (4)

Answer 8

• MAIN: schizophrenia/psychosis
• adjunctive treatment for bipolar (or benzodiazepines)
• NCD/delirium
• ASD

Question 9

FGA side effects (4)

Answer 9

• extrapyramidal symptoms
• tardive dyskinesia
• neuroleptic malignant syndrome
• orthostatic hypotension

Question 10

SGA side effects (5)

Answer 10

• weight gain
• dyslipidemia
• type 2 diabetes
• accelerated CVD
• metabolic syndrome

Question 11

metabolic syndrome symptoms (5)

Answer 11

• abdominal obesity
• high triglyceride level
• low HDL cholesterol level
• hypertension
• elevated blood glucose level

Question 12

medications to counteract EPS (2)

Answer 12

• Benztropine (Cogentin)

- Amantadine (Symmetrel)

Question 13

antipsychotics for ASD (2)

Answer 13

• Risperidone (Risperdal)
• Aripiprazole (Abilify)

these are the ONLY FDA apporved agents for ASD

Question 14

how long does it take for antipsychotics to take effect?

Answer 14

1-2 weeks

Question 15

examples of SSRIs

Answer 15

• Fluoxetine (Prozac)

- Sertraline (Zoloft)

Question 16

how long does it take for SSRIs to take effect?

Answer 16

4-6 weeks

Question 17

how long should you take antidepressants for?

Answer 17

6-12 months

Question 18

SSRI side effects (6)

Answer 18

• headache
• nausea – serotonin receptors in our gut
• insomnia/anxiety
• weight gain/loss
• sexual dysfunction
• serotonin syndrome

Question 19

serotonin syndrome

Answer 19

• rare but life-threatening side effect of SSRIs
• most often caused by drug-drug interaction
• treat by removing agent and administering meds that block serotonin receptors

Question 20

serotonin syndrome side effects

Answer 20

diarrhea, restlessness, agitation, hyperreflexia, autonomic instability, myoclonus, seizures, delirium, coma, status epilepticus, cardiovascular collapse

Question 21

types of antidepressants (5)

Answer 21

• selective serotonin reuptake inhibitors (SSRIs)
• serotonin-norepinephrine reuptake inhibitors (SNRIs)
• tricyclics
• monoamine oxidase inhibitors (MAOIs)
• heterocyclics

Question 22

how long does it take for mood stabilizers/anticonvulsants to take effect?

Answer 22

1-3 weeks

Question 23

pharmacologic treatment for bipolar disorder

Answer 23

mood stabilizers + adjunctive treatment with antipsychotics/benzodiazepines until symptoms resolve

Question 24

lithium

Answer 24

• trade: Eskalith, Lithobid
• only true mood stabilizer
• has narrow therapeutic range

Question 25

lithium therapeutic range

Answer 25

- acute mania: 1.0-1.5 mEq/L | - maintenance: 0.6-1.2 mEq/L

Question 26

lithium side effects (8)

Answer 26

- drowsiness, dizziness, headache - dry mouth, thirst, dehydration - GI upset, nausea/vomiting - fine hand tremors - polyuria - weight gain - acne - lithium toxicity

Question 27

lithium toxicity can cause (5):

Answer 27

- renal impairment - nephrogenic diabetes insipidus - hypotension - arrhythmias - pulse irregularities

Question 28

examples of anticonvulsants (3)

Answer 28

- Valproic acid (Depakene, Depakote) - Lamotrigine (Lamictil) - Carbamazepine (Tegretol)

Question 29

Valproic acid side effects (5)

Answer 29

- sedation - weight gain - hepatotoxicity with liver failure - pancreatitis - prolonged bleeding time

Question 30

Lamotrigine side effect

Answer 30

Steven Johnson’s Syndrome – disorder of skin and membranes; rash, burn-like

Question 31

Carbamazepine side effects (3)

Answer 31

- Stevens Johnson’s Syndrome - aplastic anemia - hyponatremia

Question 32

antipsychotics for bipolar disorder (3)

Answer 32

- Olanzapine (Zyprexa) - Quetiapine (Seroquel) - Risperdone (Risperdal)

Question 33

benzodiazepines indications (3)

Answer 33

- adjunctive treatment for bipolar (or antipsychotics) - NCD/delirium - given with IM antipsychotics for schizophrenia

Question 34

examples of stimulants (3)

Answer 34

- Methylphenidate (Ritalin, Concerta) - Amphetamine (Adderall) - Lisdexamfetamine (Vyvanse)