Psychosis and Schizophrenia

Question 1

What are positive symptoms of Pyschosis and Schizophrenia?

Answer 1

Delusions, hallucinations, disorganisation

Question 2

What are negative symptoms of Pyschosis and Schizophrenia?

Answer 2

Social withdrawal, neglect, poor hygiene

Question 3

What class of drugs are 1st Gen Antipsychotics?

Answer 3

Phenothiazines

Question 4

Give 3 examples of Group 1 1st Gen Antipsychotics and their effects on sedation, muscaraninic and extra pyramidal side effects?

Answer 4

Chlorpromazine, Levomepromazine, Promazine

Most Sedation
Moderate Antimuscarinic and EPSEs

Question 5

Give an example of a Group 2 1st Gen Antipsychotics and their effects on sedation and extra pyramidal side effects?

Answer 5

Pericycazine

Moderate Sedation
Least EPSEs

Question 6

Give 3 examples of Group 3 1st Gen Antipsychotics and their effects on sedation and extra pyramidal side effects?

Answer 6

Fluphenazine, Prochlorperazine and Trifluoperazine

Moderate Sedation
High EPSEs (especially not suitable for PD patients)

Question 7

Why are Antipsychotics not suitable for PD patients?

Answer 7

Antipsychotics reduce dopamine in PD patients who already have low dopamine levels.

Question 8

What are examples of 2nd Gen Antipsychotics?

Answer 8

Amisulpride
Ariprazole
Clozapine
Olanzapine
Quetiapine
Risperidone

Question 9

Which Antipsychotics cause hyperglycaemia?

Answer 9

Clozapine
Risperidone
Olanzapine
Quetiapine
(CiROQ)

Question 10

Which Antipsychotics cause hypotension?

Answer 10

Clozapine and Quetiapine

Question 11

Which Antipsychotics cause weight gain?

Answer 11

Clozapine and Olanzapine

Question 12

How do you treat Neuroleptic Malignant Syndrome caused by Antipsychotics?

Answer 12

Stop Treatment
Treat with Bromocriptine
Should resolve in 5-7 days

Question 13

Which Antipsychotics are most likely to cause QT prolongation?

Answer 13

Pimozide and Haloperidol

Question 14

What is the Weight monitoring required for Antispychotics?

Answer 14

Weekly for the first 6 weeks
At 12 weeks
At 1 year
Then Yearly

Question 15

What is the fasting blood glucose, HbA1C and blood lipid concentration monitoring requirements for Antispychotics?

Answer 15

At the start
At 12 weeks
1 Year
Then yearly

Question 16

What are the blood pressure monitoring requirements for Antipyschotics?

Answer 16

At the start
At 12 weeks
1 Year
Then yearly

Question 17

When does ECG need to be monitored for Antipsychotics?

Answer 17

Berfore initiation

Question 18

How often do FBC, U&Es and LFTs need to be monitored for Antipsychotics?

Answer 18

Start then yearly

Question 19

When can Clozapine be used for Resistant Schizophrenia?

Answer 19

Only when 2 or more antipyschotics including 2nd Gen has been used for 6-8 weeks each.

Question 20

How often do leucocyte and differential blood count need to be monitored on Clozapine?

Answer 20

Weekly for 8 weeks
Then every 2 weeks for 1 year
Then monthly until one month after last dose

Question 21

What are 3 serious side effects of Clozapine?

Answer 21

1.Myocarditis and Cardiomyopathy
REPORT and STOP ON TACHYCARDIA

2.Agranulocytes and Neutropenia
Monitor leucocyte and differential blood counts

3.Gastrointestinal Disturbances
REPORT and STOP ON CONSTIPATION
- could be a sign of intestinal block