Psychosis and Mania Flashcards
_____ generation antipsychotics predominantly block D2 receptors
1st generation
______ generation antipsychotics are more likley to cause EPSEs
1st generation
True or false: Risperidone and Aripiprazole are 1st generation antipsychotics
FALSE - they are 2nd generation (atypicals)
What are the four types of EPSEs?
- Parkinsonian symptoms
- Dystonia
- Akathisia
- Tardive dyskinesia
Symptoms of ______ include: hyperthermia, fluctuation consciousness, muscle rigidity, autonomic dysfunction, labile BP
Neuroleptic malignant syndrome
True or false: antipsychotics can cause QT prolongation
TRUE
If a clozapine dose has been missed for _______ the dose will need to be re-titrated
> 48 hours
True or false: clozapine can be used in Parkinson’s disease
TRUE - it is indicated for psychosis in Parkinson’s disease
True or false: Carbamazepine can be used for prophylaxis of bipolar disorder
TRUE
Should be used under specialist supervision
True or false:
When given to the elderly, reduce the initial antipsychotic dose to half the normal adult dose
TRUE
The elderly are more susceptible to side effects
True or false: Aripiprazole increases prolactin causing hyperprolactinaemia
FALSE
Aripiprazole actually reduces prolactin levels because it is a dopamine receptor PARTIAL agonist
(Unlike other antipsychotics that are DA antagonists)
How do antipsychotics cause hyperprolactinaemia ?
DA inhibits prolactin release
DA receptor blockade by antipsychotics prevents inhibition = more prolactin released
Which antipsychotic is less likely to prolong the QT interval
Aripiprazole
BNF
How long should an antipsychotic be tried for before it is deemed ineffective?
4-6 weeks
True or false:
Amisulpride and aripiprazole have a low risk of causing diabetes and weight compared to other second generation antipsychotics
TRUE
Which 1st generation Antipsychotic drugs are least likely to cause weight gain
(2 points)
sulpiride
trifluoperazine
NB: there are other drugs also but they are not used as often
Clozapine monitoring schedule ? (For white cell count)
Weekly for 18 weeks
Fortnightly for up to 1 year
Then monthly
Which antipsychotic is known to cause hypersalivation
Clozapine
Treat with antimuscarinics e.g. glycopyrronium
What drug is used to treat hypersalivation caused by clozapine
Hyoscine hydrobromide
Clozapine dose has to be retitrated if a dose is missed for _____
48 hours
Difference between dyskinesia and tardive dyskinesia
Dykinesia is the general term for involuntary movements
Tardive dyskinesia occurs after treatment with antipsychotics and affects the lips, tongue, face and jaw
Antipsychotics used for treatment of mania in bipolar disorder?
(4 points)
- Haloperidol
- Olanzapine
- Quetiapine
- Risperidone
Treatment options for depressive episodes associated with bipolar disorder?
(4 points)
- Fluoxetine AND Olanzapine
- Olanzapine alone
- Lamotrigine
- Quetiapine
Which antipsychotics do not require monitoring of prolactin levels
(4 points)
Olanzapine
Aripiprazole
Clozapine
Quetiapine
