Meds_Guidlines_2 Flashcards
antipsychotic with Least effect on lipid profile 🕴️
Aripiprazole 🕴️
Max dose for aripiprazole per day
30 mg/day
Aro30
Max dose per day for olanzapine
20mg/day
Ola20
Max dose perday for clozapine
900 mg/day
900 cluez
Minimum effective dose for amisulpride in 1st psychotic episode
300 mg
Minimum effective dose for risperidone in relapse of schizophrenia
4 mg
Minimum dose of olan for 1st episode of psychosis 🧑🌾
5 mg
Minimum dose of olan in relapse of schziophrenia
7.5 mg
When creatinine phosphokinase monitoring is indicated?
Baseline, if NMS, is suspected (muscle stiffness)
What does NMS increase risk of?
Rhabdomyolysis
Annual monitring for patients on quetiapine 😇
Thyroid function test 😇
Its monitoring required in case of antipsychotics prescription at baseline, 3 months and yearly
Blood lipid
Frequency of monitoring blood lipid check in case of antipsychotic prescription
Baseline, 3 months and annually
Alternative to olanzapine 🧑🌾 & quetiapine 😇 and drug induced orthostatic hypotension 😎
Amisulpride 😎
Diagnosis of orthostatic hypotension
A fall in systolic blood pressure >20
a fall in diastolic >10
Most commonly caused anticholinergic side effect 🥷
Clozapine 🥷
Least association with orthostatic hypotension 🕴️
Aripiprazole 🕴️
An antipsychotic that is more likely to cause high prolactine (dyspareunia, amenorrhaea) 🧖♂️
Haloperidol 🧖
an antipsychotic Most commonly associated with metabolic syndrome 🧑🌾
Olanzapine 🧑🌾
Alternative to risperidone indused sexual dysfunction 🕴️
Aripiprazole 🕴️
Most associated with rapid bipolar disorder
Hypothyroidism
Most effective drug for treating psychosis associated with parkinson’s 😇🥷
Clozapine 🥷and quetiapine😇
1st line of treatment in GAD if psychological approach failed 😁
sertraline (well tolerated) 😁
Not to be prescribed in panic disorders
Diazepam (benzodiazepam)
What should patients be monitored for in GAD patients under SSRI AND SNRI
suicidal thinking
frequency of suicidal thinking monitoring in GAD patients on SSRI AND SNRI
weekly for the 1st month for all<30 year olds
1st line treatment in panic disorder
SSRI
in case of no response to SSRI in Panic disorder alternative can be…🪕🤓
Imi pramine 🪕
Clomi pramine🤓
How long should one wait for SSRI to work before switching to alternatives in panic disorder
12 weeks (NICE)
1st line treatment for PTSD
trauma focussed CBT
1st line treatment in social anxiety disorder in children (<16)
Group CBT
least likely TCA to treat atypical depression🧐
Dosulepin🧐
Best for atypical antidepression
MAOIs( increase NE,5ht, and da)
Alternative to failed non pharma approach in children with Autism with sleep problem 🥱
Melatonin🥱
FDA approved 2nd gen antipaychotics for children with austism and aggression and irritability 🕴️🤽♂️
Aripiprazole🕴️
Risperidone🤽♂️
When pharmacological intervention can be considered in irritability associated with autism in children?
When non-pharma and psychological approach failed.
Most reliable drug associated with higher risk of autism when used during pregnancy 💘
Valproate 💘
Its long term use can cause b12 deficiency
Lanzoprazole ( ppi)
Best antipsychotic treatment for mania in children 🕴️
Aripiprazole 🕴️
Appropriate medication for children with depression mania 😇
Quetiapine 😇
Do not offer it to child bearing age women with bipolar 💘
Valproate 💘
Reasonable alternatives to aripiprazole in treating moderate to severe manic episodes in children 🧑🌾🤽♂️😇
Olan 🧑🌾, risperidone🤽♂️, quetiapine😇
recommended in opiod withdrawal symptoms
lofexidine
a2 adrenergic agonist & reduces Noradrenalinr in brain so reduces reslessness and irritability
Ultra rapid opiod detox
Naloxone (over 24 hr) under GA.
Not recommended by NICE
rapid opiod detox
naloxone + naltrexon (1-5 days) only with sedation and only when patient specifically asked for it
What is a long-term side effect of clozapine related to gastrointestinal function? 🥷
Gastrointestinal hypomotility
Gastrointestinal hypomotility refers to a decrease in the movement of the gastrointestinal tract, leading to potential complications such as constipation.
What neurological side effect is associated with clozapine?
Seizures
Seizures can occur as a side effect of clozapine, particularly at higher doses.
What type of infections are increased as a long-term side effect of clozapine?
Pneumonia and other acute respiratory tract infections
Clozapine may increase the risk of respiratory infections due to its immunosuppressive effects.
What cardiovascular side effect is associated with clozapine? 🥷
Tachycardia
Tachycardia is an increase in heart rate that can occur as a side effect of clozapine treatment.
Fill in the blank: A heterogeneous group of side effects from clozapine includes _______ and neutropenia.
diabetes
Diabetes can be a metabolic side effect of clozapine, contributing to weight gain and other metabolic issues.
What is the cumulative incidence of ileus in clozapine users?
5.3%
This indicates a significant risk associated with clozapine use.
What is the cumulative incidence of pneumonia in clozapine users?
29.5%
This reflects a high adverse side effect burden in patients using clozapine.
What is the odds ratio for mortality associated with ileus in clozapine users?
4.5
This suggests that the risk of death is significantly higher for those experiencing ileus.
What is the odds ratio for mortality associated with pneumonia in clozapine 🥷 users?
2.8
This indicates an increased risk of death for patients who develop pneumonia while on clozapine.
