Prescribing for Psychotic Disorders Flashcards
Which of the following therapeutic objectives is most directly associated with the use of atypical antipsychotics in the treatment of schizophrenia?
Options:
a) To eliminate all psychotic features
b) To improve cognitive functioning
c) To reduce suicidal behavior
d) To address extrapyramidal symptoms
c) To reduce suicidal behavior.
Rationale: Atypical antipsychotics are known for their ability to address not only psychotic symptoms but also mood-related symptoms such as dysphoria and suicidal behavior. While improving cognitive functioning and reducing extrapyramidal symptoms are important, the unique ability of atypical agents to mitigate suicidal risk is a significant therapeutic objective.
When considering pharmacotherapy for a patient with schizophrenia presenting with aggression and violent behavior, which medication class is preferred?
Conventional antipsychotics, such as chlorpromazine and haloperidol, are typically more effective in managing acute aggression and violent behavior due to their potent dopamine antagonism. Atypical antipsychotics may also be used, but conventional agents are often preferred for immediate control of severe symptoms.
A patient on an atypical antipsychotic develops significant weight gain and hyperglycemia. What is the primary role of the primary care provider in this situation?
he primary care provider’s role includes monitoring for side effects of psychiatric medications, such as weight gain and hyperglycemia, and addressing cardiovascular risk factors. If side effects are problematic, consultation with the psychiatrist is essential for possible medication adjustment or alternative treatment options.
In providing care for a patient with a psychotic disorder, which of the following should be monitored regularly to assess the risk of cardiovascular issues?
Monitoring the Q-T interval is crucial for patients on antipsychotics, as these medications can cause cardiac dysrhythmias, including Q-T prolongation.
What is a critical consideration when developing a crisis action plan for a family member of a patient with schizophrenia?
Developing a written plan for recognizing prodromal symptoms.
Rationale: A crisis action plan should include strategies for recognizing early warning signs or prodromal symptoms to enable timely intervention.
According to NICE guidelines, which of the following is the most appropriate first-line treatment for an acute manic episode in a patient with bipolar disorder?
NICE guidelines recommend lithium as a first-line treatment for acute mania due to its effectiveness in stabilizing mood and reducing manic symptoms. While other medications like quetiapine may also be effective, lithium is specifically highlighted for its strong evidence base in this context.
What is the recommended approach for managing a patient with bipolar disorder who experiences rapid cycling?
c) Consider the use of a mood stabilizer with anticonvulsant properties.
Rationale: For patients with rapid cycling bipolar disorder, the NICE guidelines suggest considering medications like valproate or lamotrigine, which have anticonvulsant properties and are effective in stabilizing mood in such cases. Increasing the dose of a mood stabilizer without addressing cycling specifically may not be effective.
What monitoring is essential for patients receiving long-term treatment with lithium, according to NICE guidelines?
b) Regular monitoring of serum lithium levels.
Rationale: NICE guidelines emphasize the importance of regular monitoring of serum lithium levels to ensure therapeutic efficacy and prevent toxicity, as lithium has a narrow therapeutic range. While monitoring thyroid function is also important, the frequency is not specified as monthly.
According to NICE guidelines, what is the recommended duration for the continuation phase of treatment following the stabilization of a bipolar episode?
b) 6 to 12 months.
Rationale: The NICE guidelines recommend continuing treatment for a minimum of 6 months to 1 year after stabilization of an acute episode to prevent relapse. This duration helps in maintaining mood stability and reducing the risk of future episodes.
Which psychosocial intervention is recommended as an adjunct to pharmacotherapy for bipolar disorder by the NICE guidelines?
Psychoeducation is recommended by NICE as an effective psychosocial intervention to help patients understand their condition, recognize early signs of mood episodes, and improve adherence to treatment. It is crucial for empowering patients and enhancing their self-management.
