schizo Flashcards
What agents have high risk of QT prolongation?
chlorpromazine
thioridazine
haloperidone
ziprasidone
iloperidone
What agents have high metabolic risk?
olanzapine
clozapine
risperidone
paliperidone
quetiapine
What agents should you use if metabolic risk is a concern?
aripiprazole
ziprasidone
lurasidone
asenapine
What agents lower seizure threshold?
clozapine
chlorpromazine
What agents may cause insomnia?
aripiprazole, brexpiprazole
What agents may cause dizziness?
asenapine
iloperidol
brexpiprazole
cariprazole
What agents may cause impulsivity?
aripiprazole
What agents are prolactin-elevating?
FGAs
risperidone
paliperidone
olanzapine
What agents have anticholinergic effects?
chlorpromazine
thioridazine (highest)
clozapine
olanzapine
What agents have highest EPS?
haloperidol
fluphenazine
At high doses, which SGAs have EPS?
risperidone
paliperidone
Smoking has drug interaction with
olanzapine
clozapine
(reduces levels via CYP1A2)
Antacids have drug interaction with
(reduce absorption of) chlorpromazine
What has interactions with olanzapine-samidorphan?
3A4, 1A2, opioid withdrawal/dependence
What has interactions with lumateperone?
3A4
risperidone LAI frequency
2 weeks
paliperidone (Invega Sustenna) LAI frequency
1 month
paliperidone (Invega Trinza) LAI frequency
3 months
paliperidone (Invega Hafyera) LAI frequency
6 months
aripiprazole (Abilify Maintena) LAI frequency
1-2 months
aripiprazole (Aristada) LAI frequency
1-2 months
haloperidol decanoate LAI frequency
1 month
fluphenazine decanoate LAI frequency
2 weeks
olanzapine LAI frequency
2-4 weeks
What agents are available as OROS capsules?
paliperidone (once a day)
What agents are available as ODT?
aripiprazole
olanzapine
risperidone
What agents are available as sublingual tablets?
asenapine
What agents are available as transdermal patches?
asenapine
What agents are available as liquids?
aripiprazole
haloperidol
fluphenazine
risperidone
What agents should be taken with food? Minimum calories?
ziprasidone, 500 calories
lurasidone, 350
lumateperone
What agents can cause somnolence?
asenapine
iloperidone
lurasidone
lumateperone
cariprazine
Which agent is contraindicated to acute respiratory s/s, asthma, COPD or other lung disease associated with bronchospasm?
loxapine
Which agent is available as an oral inhalation powder?
loxapine
Which agent may cause blue/gray discoloration of skin?
chlorpromazine
What can be used to treat acute dystonia?
benztropine
diphenhydramine
What can be used to treat akithisia?
propanolol
clonidinep
What can be used to treat pseudoparkinsonism?
benztropine
ropinirole
What can be used to treat tardive dyskinesia?
valbenazine
deutetrabenazine
What is the MoA of valbenazine and deutetrabenazine?
VMAT2 inhibitor
Neuroleptic malignant syndrome is a warning for which EPS medications?
deutetrabenazine
What should you do for a patient who is experiencing EPS on an antipsychotic agent?
Reduce dose OR switch to other agent with lower risk of EPS
What may a patient experience during neuroleptic malignant syndrome?
Hyperthermia, confusion, stupor, diaphoresis, tachycardia,
increase CPK and muscle rigidity
How should you treat a patient experiencing neuroleptic malignant syndrome?
D/C antipsychotics
use dantrolene, BZDs, or dopamine agonists
Neuroleptic malignant syndrome is more likely to occur when:
-a patient is taking typical antipsychotics
-after high dose IM injections
-after recent initiation
Difference between FGA and SGA mechanism of action?
Both D2 antagonists
Only SGAs are partial serotonin receptor antagonists
Which agent may cause excessive drooling?
clozapine
Which agent has a BBW on neutropenia and myocarditis?
clozapine
What is the MoA of samidorphan?
mu-opioid receptor antagonist
kappa-/delta-opioid receptor partial agonist
What are contraindications to olanzapine-samidorphan?
opioid use or acute opioid withdrawal
What agent should not be used in end-stage renal disease?
olanzapine-samidorpan
Which LAI has a BBW for severe sedation/coma?
olanzapine (Zyprexa Relprevv)
Which agent can cause rare but serious skin reactions? (DRESS)
olanzapine-containing agents
what agents are prolactin sparing
clozapine
quetiapine
ziprasidone
aripiprazole