Psychosis

Question 1

What are false sensory perceptions

Answer 1

hallucinations

Question 2

what are false beliefs versus evidence to the contrary

Answer 2

delusions

Question 3

acute disturbance of consciousness and cognition

Answer 3

Delirium

Question 4

Severe chronic disorder with periods of active psychosis and persistent deterioration in social, occupational, scholastic, and personal functioning

Answer 4

Schizophrenia

Question 5

Psychosis secondary to medical problems could include

Answer 5

Neurologic problems
Endocrine dysfx
Metabolic issues
Hepatic & Renal disorders
Autoimmune disorders

Question 6

Schizophrenia diagnoses requires

Answer 6

Atleast one of the following:

• delusions
• hallucinations
• disorganized speech

Question 7

Typical antipsychotics include

Answer 7

Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
Perphenazine (Stelazine)
Haloperidol (Haldol)
\+many more (these were the ones  he highlighted)

Question 8

What is approved for intractable hiccups?

Answer 8

Thorazine

Question 9

How do typical antipsychotics work?

Answer 9

Block D2(wanted) and D1 (unwanted)

Question 10

Which antipsychotic is more specific for D2?

Answer 10

Haloperidol

Question 11

ADRs of typical antipsychotics

Answer 11

Tachycardia
Dizzy
Hypotension
Impotence
Hyperprolactinemia
Wt gain
Risk of death (in elderly pts with dementia)
movement disorders
-extrapyramidal symptoms
-tardive dyskinesias (after 6m-2yrs tx)

Question 12

Class effect for phenothiazines

Answer 12

QTc prolongation

=get EKG at baseline

Question 13

Dose a typical antipsychotic for management of schizophrenia

Answer 13

Haloperidol 5mg twice a day

Question 14

Atypical antipsychotics include

Answer 14

Clozapine (Clozaril)
Olanzapine (Zyprexa)
Aripiprazole (Abilify)
Quetiapine (Seroquel)
\+ many more

Question 15

Which atypical antipsychotic is most specific to D2

Answer 15

Aripiprazole

Question 16

Are atypicals superior to typicals?

Answer 16

No evidence, side effect profile may favor atyipcals

Question 17

What population should not receive atypical antipsychotics?

Answer 17

Elderly

-increased mortality risk

Question 18

ADRs of atypicals

Answer 18

Metabolic: Wt gain, hyperlipidemia, hyperglycemia
Prolactin elevation
Seizure risk
orthostatic hypotension
neuroleptic malignant syndrome
qt prolongation
sudden death

Question 19

Dose an atypical antipsychotic

Answer 19

Abilify 15mg once a day

Question 20

How can you improve adherence for antipsychotics?

Answer 20

Sustained action injections

• Haloperidol decanoate
• Abilify Maintena (once monthly)
• Invega Sustenna
• Risperdal Consta