Psychosis and schizophrenia

Question 1

What are the 2 types of symptoms in psychosis and schizophrenia?

Answer 1

positive= when something is adding to your body e.g. delusions, hallucinations and disorganisation
negative= when there is a withdrawal to your life e.g. social withdrawal, neglect, poor hygiene

Question 2

what are the 2 types of drugs used in psychosis and schizophrenia? and which one do we use mostly?

Answer 2

1st gen and 2nd gen
use 2nd gen more

Question 3

within the 1st gen phenothiazines how many sub-groups do they have?

Answer 3

3

Question 4

what drugs are included in group one of phenothiazines?

Answer 4

ones including -promazine
chlorpromazine, levomepromazine, promazine

have the most sedation, moderate antimuscarinic and EPSEs (extra-peridial SE) =SHOUDLNT BE USED IN PARKINSONS PATINETS

Question 5

what drugs are in group 2 phenothiazines?

Answer 5

pericyazine
-moderate sedation and least EPSEs

Question 6

what drugs are in group 3 phenothiazines?

Answer 6

-fluphenazine, prochlorperazine, trifluoperazine
-moderate sedation, high EPSEs

Question 7

what are some other 1st gens drugs?

Answer 7

-butyophenones
-thioxanthenes
-other

Question 8

what drugs are the drugs under the category of butyophenones?

Answer 8

-benperidol and haloperidol
-moderate sedation, high EPSEs

Question 9

what drugs are the drugs under the category of thioxanthenes?

Answer 9

flupentixol and zuclopenthixol
-moderate sedation, antimuscarinic effects and EPSEs

Question 10

what drugs are the drugs under the category of other?

Answer 10

pimozide and sulpiride
-reduced sedation, antimuscarincic effects and EPSEs

Question 11

what are examples of 2nd gen antipsychotics?

Answer 11

amisulpride
aripiprazole
clozapine
olanzipine
quetiapine
risperidone

Question 12

what 2nd gen antipsychotics cause the most weight gain?

Answer 12

olanzapine and clozapine

Question 13

what are some side effects of antipsychotics?

Answer 13

-extrapyramidal SE= most in group 3 phenothiazines and butyrophenones

-hyperprolactinaemia: least in aripirazole
-sexual dysfunction: all antipsychotics
-cardiovascular SE: QT prolongation most commit with pimozide and haloperidol
-hypotension: in clozapine and quetiapine
hyperglycaemia: Clzaoine, risperidone, olanzapine and quetiapine
-weight gain: clozapine and olanzapine

Question 14

what should be used to treat neuroleptic malignant syndrome?

Answer 14

stop treatment then treat with bromocriptine then should resolve in 5-7 days

Question 15

what is the monrioting for antipsychotics?

Answer 15

-weight: start, weekly for first 6 weeks, at 12 weeks at 1 year then early
-fast blood glucose, HbA1c and bloop lipid conc: start, at 12 weeks at 1 year then yearly
-ECG:before initiation
-blood pressure: start, at 12 weeks at 1 year then yearly
-FBC, U&Es and LFTs: start then yearly

Question 16

what drug is used for resistant psycosis and schizophrenina?

Answer 16

clozapine

Question 17

what is considered as resistant?

Answer 17

2 or more antiychottics including a 2nd gen has been used for 6-8 weeks each

Question 18

when do you need to be reinitiated with clozapine ?

Answer 18

when you miss 2 or more doses

Question 19

how often do you need to monitor leucocytes and inferential blood counts?

Answer 19

-weekly for 8 weeks
-fortnightly till one year
-then monthly and then one month after their last dose

Question 20

what are the side effects of clozapine?

Answer 20

MAG
-myocardtisi and cardiomyopathy=report and stop on tachycardia
-agranulocytes and neutropenia= monitor leucocytes and differential blood counts
-gastrointenstinal disturbances= report and stop on constipation can lead to intestinal block