Module 5 - antipsychotics part 2

Question 1

symptoms of Neuroleptic Malignant Syndrome (NMS)

Answer 1

reduced consciousness
Increased muscle tone
autonomic dysfunction (hyperpyrexia, hypertension, tachycardia, cog-wheeling)

Question 2

Good first-line antipsychotics

try for 4 weeks

Answer 2

aripiprazole
risperidone
ziprasidone
cariprazine

Question 3

Good second choice if first choice is inadequate or intolerable

Answer 3

olanzapine, risperidone, or FGA

Question 4

Choose this drug if first two choices fail

Answer 4

Clozapine

Question 5

most associated with weight gain and metabolic risk

Answer 5

olanzapine

clozapine

Question 6

moderate metabolic risk

Answer 6

risperidone, paiperidone, quetiapine, iloperidone

Question 7

low metabolic risk

Answer 7

ziprasidone
aripiprazole
lurasidone
asenapine

Question 8

Weight neutral SGA

Answer 8

Geodon (ziprasidone)

Question 9

SGA most likely to cause increased prolactin level

Answer 9

Risperdal

Question 10

FGAs method of action

Answer 10

block D2 receptors in all four pathways

Question 11

pseudoparkinsonism signs

Answer 11

stooped posture
shuffling gait
rigidity
pill rolling
tremors

Question 12

acute dystonia signs

Answer 12

facial grimacing
involuntary eye movement
muscle spasms in face, neck, tongue
laryngeal spasms

Question 13

akathisia signs

Answer 13

restless
pacing
feet in constant motion

Question 14

Tardive dyskinesia

Answer 14

tongue rolling
mouth/chewing motion
Involuntary movements of body and extremities

Question 15

1st line treatment for dystonia

Answer 15

beztropine

diphenhydramine

Question 16

first line treatment for parkinsonism

Answer 16

benztropine

trihexyphenidyl

Question 17

first-line treatment for akathisia

Answer 17

propanolol

benzodiazepine

Question 18

first-line treatment for TD

Answer 18

deutetrabenazine (Austedo)
Vlabenazine (Ingrezza)
*watch for QT prolongation

Question 19

SGA mechanism of action

Answer 19

Block 5HT2A and D2 receptors