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PSYCHOPHARMA - MIDTERM > MODULE 14 > Flashcards

MODULE 14 Flashcards

1
Q

when the only pathology is the psychotic disorder itself

A

PRIMARY PSYCHOSIS

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2
Q

when the symptoms are a result of a general medical condition or substance-induced.

A

SECONDARY PSYCHOSIS

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3
Q
  • has rapid onset and generally follows an identifiable stressor; characterized by emotional turmoil, mood changes and confusion, along with the presence of one or more of the following symptoms: delusions, hallucinations, disorganized speech or grossly disorganized or catatonic behavior.
  • lasting at least one day; < than one month
A

BRIEF PSYCHOTIC DISORDER

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4
Q

involves the presence of sometimes elaborate, non-bizarre delusions

A

DELUSIONAL DISORDER

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5
Q
  • with features of both schizophrenia and a mood component such as depression or mania.
  • does not strictly meet criteria for either schizophrenia or a mood disorder alone
A

SCHIZOAFFECTIVE DISORDER

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6
Q

“short-episode of schizophrenia”, lasting at least one month, but less than six months.

A

SCHIZOPHRENIFORM

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7
Q
  • involves psychotic phase characterized by prominent psychotic features, such as delusions, hallucinations and gross impairment in reality testing; persists for at least six months.
  • has significant genetic component.
  • onset is influenced by psychosocial and environmental factors
  • age of onset: 18-20 for men, and mid-twenties for women.
  • 11-15 years old: adolescent age onset for both sexes
A

SCHIZOPHRENIA

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8
Q

delusions, hallucinations, exaggerations in language and communication, disorganized and behaviors

A

PRIMARY SYMPTOMS

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9
Q

anhedonia, emotional withdrawal, passivity, apathy, dulled affect, or emotional flattening

A

NEGATIVE SYMPTOMS

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10
Q

incoherence, loose associations, impaired attention, impaired information

A

COGNITIVE SYMPTOMS

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11
Q

Medical Disorders Influencing Psychotic Features
These must be ruled out in order to make an accurate diagnosis of schizophrenia.
1. I___c_ions
2. Tu___s
3. End-Stage Re__l Di___se
4. Hyp__lycemi_
5. De___tias
6. Str__e
7. Head i___ries
8. Vi___in deficiencies, particularly th___ine

A
  1. Infections
  2. Tumors
  3. End-Stage Renal Disease
  4. Hypoglycemia
  5. Dementias
  6. Stroke
  7. Head injuries
  8. Vitamin deficiencies, particularly thiamine
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12
Q

Medical Disorders Influencing Psychotic Features
Drugs influencing psychotic features:
1. Ca_____is
2. Amphe____es
3. Ha_____gens
4. A_c__ol
5. O___tes

A
  1. Cannabis
  2. Amphetamines
  3. Hallucinogens
  4. Alcohol
  5. Opiates
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13
Q

T or F
Antipsychotics block DOPAMINE receptors in the central nervous system.

A

T

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14
Q

T or F
the blocking actions on dopamine receptors in the limbic system are thought to underlie the effectiveness of these agents in managing the “NEGATIVE symptoms” of schizophrenia

A

F.
in managing the “POSITIVE symptoms” of schizophrenia

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15
Q

T or F
may or may not be sedating, depending on product selection.

A

T

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16
Q

Conventional Agents/ Dopamine-Receptor Antagonists (First-Generation Antipsychotics) (memorize lang guro)

A

Indications para gamitan ng Conventional Agents:
1. Acute psychotic episodes
2. Maintenance treatment
3. Mania
4. Depression with psychotic symptoms
5. Delusional disorder
6. Borderline personality disorder
7. Substance-induced disorder
8. Delirium and dementia
9. Mental disorders caused by medical condition
10. Childhood schizophrenia
11. Pervasive developmental disorder
12. Tourette’s disorder
13. Huntington’s disease

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17
Q

T or F
Conventional Agents/ Dopamine-Receptor Antagonists (First-Generation Antipsychotics)

They are effective in treating MANIA but ineffective in managing bipolar depression.

A

T.

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18
Q

T or F
Conventional Agents/ Dopamine-Receptor Antagonists (First-Generation Antipsychotics)

They are are responsible for a group of neurological adverse events known as EXTRAPYRADIAL SYMPTOMS.

A

F.
EXTRAPYRAMIDAL SYMPTOMS

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19
Q

characterized by muscle-TIGHTENING in the neck and shoulders, accompanied by SPASMS.

A

Dystonia

20
Q

produces muscle rigidity, MASK-LIKE facies, TREMOR, shuffling gait and diminished arm-swinging.

A

Parkinsonian

21
Q

MOTOR-RESTLESSNESS, a need to move and

A

Akathisia

22
Q

INVOLUNTARY FACIAL MOVEMENTS involving the tongue, eyes, lips and face.

A

Tardive Dyskinesia

23
Q

T or F

When an EPS manifestation develops, one treatment is to add a dosage of the offending drug

A

F.
one treatment is to LOWER the dosage of the offending drug

24
Q

Adverse effects of conventional agents:
1. Neu___ptic Malignant Syndrome
2. Seda___n
3. Central Anti___nergic Effects
4. C____iac Effects
5. Sudden D__th
6. S____al Adverse Effects
7. S__n and Eye Effects
8. Jau___ce

A
  1. Neuroleptic Malignant Syndrome
  2. Sedation
  3. Central Anticholinergic Effects
  4. Cardiac Effects
  5. Sudden Death
  6. Sexual Adverse Effects
  7. Skin and Eye Effects
  8. Jaundice
25
Q

Other side effects of Conventional Agents:
1. Dry m__th, bl___d vision, con___pation, se___ion and m___ry problems
2. W___ht gain
3. Grand mal sei___es
4. Increased levels of p___actin
5. Neu___eptic ma___nant syndrome
6. Or___static hy___ension

A
  1. Dry mouth, blurred vision, constipation, sedation and memory problems
  2. Weight gain
  3. Grand mal seizures
  4. Increased levels of prolactin
  5. Neuroleptic malignant syndrome
  6. Orthostatic hypotension
26
Q

T or F
Atypical Antipsychotic Agents/ Serotonin-Dopamine Antagonists (Second-Generation Antipsychotics)

developed to MEET the TREATMENT NEEDS of those UNRESPONSIVE to the CONVENTIONAL AGENTS and to improve the overall tolerability

A

T.

27
Q

T or F
Atypical Antipsychotic Agents/ Serotonin-Dopamine Antagonists (Second-Generation Antipsychotics)

not a single, HETEROGENOUS class of drugs

A

F.
HOMOGENOUS

28
Q

T or F
Atypical Antipsychotic Agents/ Serotonin-Dopamine Antagonists (Second-Generation Antipsychotics)

STRONG serotonin blockers

A

T.

29
Q

T or F
Atypical Antipsychotic Agents/ Serotonin-Dopamine Antagonists (Second-Generation Antipsychotics)

carry a LOWER RISK of EPS

A

T.

30
Q

T or F
Clozaril (clozapine) - the MOST effective, but also the most dangerous

A

T!
Clozaril: A Double-Edged Sword (ang naa sa pdf kay galahi2 clozaril-clorazil pero pag search nako clozaril ang gagawas)

31
Q

What drug was introduced in the United States in 1990, after being used in Europe since the 1970’s. It is not a first-line drug of choice, and careful monitoring is necessary as it has double-edged effects.

A

CLOZARIL (CLOZAPINE)

32
Q

Benefits of Clozaril
-“G__d Standard” effectiveness
-Some improvement in co___tive function
-Effective in decreasing ha__inations and del___ons
-FDA-approved for the treatment of re__rent su___dal behavior
-Can help with smoking ce___tion in some patients
-Can diminish symptoms of ag___sion and vio___ce
-Can reduce al___ol use in patients who abuse a___hol
-Very low incidence of EPS and ak__isia and
-Almost no ta___ve dysk___sia

A

-“Gold Standard” effectiveness
-Some improvement in cognitive function
-Effective in decreasing hallucinations and delusions
-FDA-approved for the treatment of recurrent suicidal behavior
-Can help with smoking cessation in some patients
-Can diminish symptoms of aggression and violence
-Can reduce alcohol use in patients who abuse alcohol
-Very low incidence of EPS and akathisia and
-Almost no tardive dyskinesia

33
Q

Risks of Clozaril
-May cause agr___locytosis
-B__od work are mandated by the FDA according to established guidelines (weekly for six months, although after this period, monitoring can then take place on a biweekly basis)
-Can interact with other drugs that also d___ease WBC count, such as Tegretol (carbamazepine) and some antibiotics
-Some deaths have been reported, due to m___arditis, an inflammation or degeneration of the heart muscle
-Over-se___ion
-Major w___ht gain
-Elevated risk of Type 2 dia___es and potential for increasing triglyc___des and chol___erol
-Can cause urinary in___tinence
-Sei___es at higher doses are common (greater than 600mg/day) and
-May take many weeks, even months, to be effective

A

-May cause agranulocytosis
-Blood work are mandated by the FDA according to established guidelines (weekly for six months, although after this period, monitoring can then take place on a biweekly basis)
-Can interact with other drugs that also decrease WBC count, such as Tegretol (carbamazepine) and some antibiotics
-Some deaths have been reported, due to myocarditis, an inflammation or degeneration of the heart muscle
-Over-sedation
-Major weight gain
-Elevated risk of Type 2 diabetes and potential for increasing triglycerides and cholesterol
-Can cause urinary incontinence
-Seizures at higher doses are common (greater than 600mg/day) and
-May take many weeks, even months, to be effective

34
Q

treatment for agitation and aggression in dementia; for minimizing temper tantrums, aggression and self-injury associated with autism, as well as disruptive behavior disorders in children and adolescents (ages
5-16).

A

Risperdal (risperidone)

35
Q

provides calming action for agitation associated with schizophrenia; sedating and likely produces the most weight gain; increased risk of diabetes type 2.

A

Zyprexa (olanzapine)

36
Q

for the management of aggressive, cognitive and affective symptoms of schizophrenia; essentially no EPS; has been increasingly prescribed as a sleeping pill.

A

Seroquel (quetiapine)

37
Q

least likely cause weight gain and least sedating; advantage for associated anxiety and depression, although the drug is associated with agitation at lower doses; has been linked to cases of fatal cardiac
arrythmia.

A

Geodon (ziprasidone)

38
Q

augmenting agent in treatment-resistant unipolar depression and is increasingly being employed as augmentation to the selective serotonin reuptake inhibitors; associated with minimal weight gain and sedation;
not sedating enough to effectively manage acute agitation.

A

Abilify (aripiprazole)

39
Q

an active metabolite of Risperdal (risperidone); it also carries some cardiac risk and is metabolized primarily by the kidneys; not recommended for patients

A

Invega (paliperidone)

40
Q

must be titrated up slowly to minimize orthostatic hypotension and dizziness; cardiac effects appear to be similar to those of Geodon (ziprasidone).

A

Fanapt (iloperidone)

41
Q

available only as sublingual tablet; significant for weight gain; oral numbness

A

Saphris (asenapine)

42
Q

causes very little weight gain but is significant for sedation; metabolic syndrome is minimal; treatment for schizophrenia, major depressive episodes associated by bipolar I as monotherapy and as adjuctive therapy with lithium or valproate; very expensive.

A

Latuda (lurasidone)

43
Q

Common Side effects of Atypical Antipsychotic:
1. W___ht gain
2. Se___ion
3. Ins__ia
4. Ag__tion
5. Con___pation
6. Dry M__th
7. Increased Risk of Type II dia___es (Clorazil and Zyprexa)

A
  1. Weight gain
  2. Sedation
  3. Insomnia
  4. Agitation
  5. Constipation
  6. Dry Mouth
  7. Increased Risk of Type II diabetes (Clorazil and Zyprexa)
44
Q

most effective for positive symptoms and even negative symptoms

A

Cognitive-Behavioral and Family Therapy (CBT)

45
Q

involves bringing together several families, including the identified patients, for educational get-together

A

Family Therapy

46
Q

involves bringing together several families, including the identified patients, for educational get-together

A

Family Therapy

PSYCHOPHARMA - MIDTERM (5 decks)

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