Meds: Seizure and antipsychotics

Question 0

Dilantin

Answer 0

10-20 ug/mL therapeutic range
muscular uncoordination
nystagmus
diplopia

Question 1

Quetapine (Seroquel)

Answer 1

Wt GAIN
serious cardiac dysrythmias, syncope
NMS
Seizures

Question 2

Carbamazapine (Tegretol)

Answer 2

Monitor CBC, liver Fx, ECG

Use sunscreen

Question 3

Clonazepam (Klonopin)

Answer 3

PO w/food
behavior changes
Depression
SI

Question 4

Ethosuxinimide (Zarontin)

Answer 4

children w/food

Anorexia and other GI Sx
drowsy, dizzy
behavior changes
SI
SJ

Question 5

Gabapentin (Neurontin)

Answer 5

Depression
Ataxia
SI

Question 6

lamotrizine (lamictal)

Answer 6

Children 2-12 (chewable)
Ataxia, Diplopia
N/V
rhinitis
SI
SJ

Question 7

levetiracetem (Keppra)

Answer 7

Dizzy, Weak
SI
Behavior changes

Question 8

Phenobarbital (Luminal)

Answer 8

PO maintenance
IV-status epilepticus
1st choice neonatal seizures, status epilepticus

laryngeal spasms
angiodema
serum sickness
long term cognitive dysfunction
*monitor drug levels

Question 9

Phenytoin (Dilantin)

Answer 9

Not with Dextrose

status epilepticus - IV undiluted (1-3 mg/kg children)

diplopia, nystagmus
GINGIVAL HYPERPLASIA<<<
AGRANULOCYTOSIS<<<
APLASTIC ANEMIA
SI
SJ

Question 10

Topiramate (Topomax)

Answer 10

sprinkles or PO

SI
KIDNEY STONES «&laquo_space;use caution with ketogenic diet
Parasthesias
Anorexia

Question 11

Clozapine (Clozaril, Leponex)

Answer 11

antipsychotic - treatment resistant
ODT = Fazaclo

high ACH, OH, Sed

AGRANULOCYTOSIS
Seizures
WT GAIN
Tachycardia

Question 12

Risperidone (Risperdal, Risperdal (Mtab), Consta (IM))

Answer 12

IM inj good for teens, homeless (Consta)

Hypotension
Sexual Dysf.
Diabetes
Lipid abnormalities

Question 13

Paliperidone (Invega, Sustena)

Answer 13

IM = Sustena

Not for elderly esp w/dementia

Diabetes
Sexual dysfunction
Hypotension

Question 14

Olanzaopine (Zyprexa, Relprevv)

Answer 14

IM=Relprevv

Moderate ACH, OH

Significant Wt Gain
High Lipids
Hypotension
Akathisia or Parkinsonism

Question 15

Ziprasidone (Geodon)

Answer 15

PO/ IM
short acting

Serious ECG changes; QT prolongation

Question 16

Aripiprazole (Abilify)

Answer 16

PO, ODT, short acting IM

may cause anxiety
prolonged QT
DKA
Dyskinesia
NMS

Question 17

Iloperidone (Fanapt)

Answer 17

low-mod EPS, OH

Wt GAIN
QT interval (not 1st choice for cardiac pts)
Severe APS can cause NMS and TD

Question 18

Lurasidone HCl (Lutada)

Answer 18

PO

High EPS 
Increase BG
Increase Cholesterol
Low WBC
Akathisia
Parkinson-like Sx

Question 19

Haldol

Answer 19

3-4 week IM

high EPS
NMS
ACH
TD

Question 20

Thorazine

Answer 20

high SED
high hypOtension

EPS
irreversible retinitus pigmentosa >800gm/day

Question 21

Trifluoroperazine (Stelazine)

Answer 21

High EPS
ACH
NMS

Question 22

Fluphenazine (Prolixin)

Answer 22

IM lasts 2-4 weeks
Akathisia
Dystonia
TD
ACH

Question 23

Thioridizine (Mellaril)

Answer 23

Not recommended as first line antipsyhotic

ECG changes
prolonged QT
sudden death

Question 24

Name some medium potency antipsychotics?

Answer 24

Loxapine - NMS
Molindone - NMS
Perphenazine

all have EPS and ACH

Question 25

Lithium

Answer 25

0.5 - 1.3 mEQ/L therapeutic range

lethargy/ hand tremors - early signs of toxicity
muscle weakness

Question 26

Name some pharmacological therapies for Dementia (AD)

Answer 26

1. Cholinesterase Inhibitors (mild to moderate)
   - Razadyne, Excelon, Aricept, Cognex
2. N-methyl - D-aspartate (mod-severe)
   - Namenda

Question 27

What is NMS and treatments?

Answer 27

1. severe EPS
2. Hypoxia >103*
3. Autonomic Dysfunction

Rx= Parledol (fever, rigidity)
Dantrium (spasms)
can occur in 1st week and on

Question 28

Onset of TD

Answer 28

onset months - years
-no known treatment
Screening every 3 months

Question 29

Acute Dystonic reactions

Answer 29

acute contractions of face, neck, tongue, back

onset 1-5 days
treatment: Benadryl (25-50 mg) IV, IM = first choice
Benzotropine (1-2 mg) IV, IM

Question 30

Treatment for Pseudoparkinsonism?

Answer 30

alert medical staff
-Artane, Congentin, Akineton

onset 5 hours- 30 days

Question 31

Treatment for Akathisia

Answer 31

Inderol (propenalol), Valium, Ativan

onset 2 hours - 60 days