Psych drugs Flashcards
SGA that cause hypertriglyceridemia
Clozapine, Olanzapine, Quetiapine
SGA that cause significant weight gain
Clozapine and Olanzapine
SGA that might cause weight gain
Aripiprazole, Brexipiprazole, Cariprazine, Lurasidone, Ziprasidone
SGA that cause EPS ADEs
Risperidone and Paliperidone
SGA least likely to cause EPS ADEs
Quetiapine and Clozapine
SGA that increase prolactin
Risperidone and Paliperidone
SGA that prolong QTc
Clozapine, Ziprasidone, Paliperidone, Quetiapine, Iloperidone
SGA with anticholinergic
Olanzapine, Quetiapine, *Clozapine
SGA that cause orthostatic HoTN
Clozapine, Iloperidone
-Moderate: Quetiapine, Risperidone, Paliperidone
SGA that cause sedation
Clozapine
-Moderate: Olanzapine, Quetiapine, Ziprasidone
SGA that cause seizures
Clozapine (dose dependent)
SGA with hematologic effects
Clozapine
MOA of FGA
block D2 receptors, minimal 5-HT2A blockade
FGA ADEs
EPS- Acute dystonia, pseudoparkinsonism, akathisia, tardive dyskinesia
NMS
Dermatologic
Hyperprolactinemia
QTc prolongation (Thioridazine Haloperidol)
M1/H1/Alpha1
Acute dystonia management
Occurs w/in 24-96 hours
NO ORAL MEDS! Diphenhydramine/Benztropine IM
Pseudoparkinsonism management
Occurs w/in first month
decrease dose/swith to SGA
Benztropine, Trihexyphenidyl, or Amantadine Tx for several months
Akathisia management
Occurs w/in 3 months
Swith to SGA
Tx w/ Propranolol
Tardive Dyskinesia management
Long term exposure
discontinue anticholinergics
Ingrezza or Austedo (VMAT2 inhibitors)
Neuroleptic Malignant Syndrome (NMS) management
supportive care
Dantrolene, Bromocriptine, BDZs
wait at least 2 weeks to restart new antipsychotic therapy
Asenapine pearl
SL only, no food/drink for 10 minutes after dose
Cariprazine pearl
steady state takes several weeks
Lurasidone pearl
must take w/ at least 350 calories
Paliperidone pearls
bioavailability increased when taken w/ food
Quetiapine pearl
hypnotic at 50mg, antidepressant at 300mg, antipsychotic at 600mg
Ziprasidone pearl
must take w/ at least 500 calories
Clozapine pearls
DOC for Tx resistant Schizo (failed 2 others)
titrate slowly due to orthostatic HoTN
REMS due to risk of neutropenia- monitor ANC= total WBC x [%neutrophils (segs+bands)/100]
can initiate if ANC >1500 for most or >1000 if BEN. monitor ANC q week for 6 moths then every other week from months 6-12 then monthly after 12 months