SCHIZO Flashcards
What are the symptoms needed to diagnose schizophrenia?
Cognitive problems include like thinking people are filming you or people are out to get you.
Positive = hallucination
Cognitive: cant do math cant critically think
negative = no motivation to do shit
What is the mechanism of action of action for antipsych meds?
Meds tend to work on the dopamine (DA) 2 receptor antagonist
What are the typical antipsych meds?
What are the atypical antipsych meds?
What is the new 2024 M1/M4 agonist medication?
Xanomeline/Trospium (Cobenfy)
What do first generation antipsychotics and conventional antipsychs do that second generations do not?
First generations do not have 5HT2a antagonism but second generations do
What does binding to D2 do?
Decreases the positive symptoms of psychosis BUT it you get EPS and hyperprolactemia
What does binding to M1 do?
Mitigation of EPS
BUT: ortho hypotension, blurry , dry mouth, sinus tachy
What does binding to H1 do?
Therapeutic effect: Sedation
Bad: Drowsiness and weight gain
What does binding to alpha 1 do?
Therapeutic effects: we dunno
Bad: Reflex tachy, ortho hypo, dizziness
What guidelines do u quote for schizo management?
American Psychiatric (gout) association
5HT2A
Serotonin. Antagonism is only present in second generation antipsychotics
List some reasons for non adherence to medication
List some immediate release IM anti psychotics. When are they used?
Haloperidol + or Olanzapine are common use for acute stabilization
What are some non pharmacological approaches to schizo treatment?
What do I do when there is acute stabilization/ agitation
Should I give IM Olanzapine and IM benzo at the same time?
HELL NO
What are the phases of illness?
What is Adusave (Inhaled loxapine)?
Tell me the mechanism, precautions, adverse effects, and monitoring for sublingual dexmedetomidine.
Tell me about Xanomeline/Trospium (Cobenfy). Its ADRs, Drug interactions, Contraindications, and Special considerations
List me the drug interaction potentials (predominantly what reacts with cigarettes and what happens?)
Clozapine and Olanzapine
Give me the 4 treatment principles from slide 35?
What should I keep in mind when selecting an antipscyh med (slide 36)?
What is the safety concern for all elderly patients?
What are the general differences between FGAs and SGAs
Tell me about FGAs and tell me some examples of them
Tell me about the atypicals
Tell me about ADEs and metabolic syndrome (slide 43)
Common in atypicals
Tell me which drugs have the lowest risk vs highest risk for metabolic ADEs of SGAs
Lowest is: Aripiprazole, Ziprasidone, Lurasidone
Highest: Clozapine>Olanzapine
Compare: SGAs Ariprazole, Risperidone, Paliperidone, Quetiapine
Compare SGAs: Olanzapine, Ziprasidone, Lurasidone, Asenapine
Tell me about QT prolongation in Antipsych meds and list the lowest risk to highest risk for me.
Lowest: Abilify
Highest Ziprasidone, Haloperidol, Thiordazine
What do u monitor for FGAs? What do you monitor for SGAs?
What do I council for antipsychs?
Tell me about Clozapine tolerability and list me its black box warnings.
Not first line, only for treatment resistant schizophrenia
Tell me about clozapine’s dose initation and titration methodology.
Tell me about Clozapine induced seizures
What are the adverse effects of clozapine
It is rare to get seizures and that risk comes with rapid titration and serum concentrations over >1000 ng/ml
Tell me about clozapine serum concentration monitoring
Goal serum concentration is 350-999 ng/ml
Tell me about the clozapine REMs program
What are the requirements for Clozapine?
Tell me the rationale for long acting injectable antipsychotics (LAIS) medications
How do u transition from PO to LAIS?
Tell me about LAI formulations and routes of administration.
Give me some LAI specifics (Slide68)
DECANOATE IS SESAME OIL IT STICKS LONGER SO ITS ONLY FOR LAI
How do you administer LAIs.
What happens of ur early, miss or have a late dose?
How do i approach antipysch failure
What are the principles for switching antipsych meds
What are some treatment emergent adverse effects (TEAEs)?
What are the types of EPS and how are they treated?
What is tardive dyskinesia
What is the history in treating tardive dyskinesia
What are the new agents used to treat Tardive dyskinesia and how do they work
What is the treatment to adverse effect management for tardive medications
what is neuroleptic malignant syndrome and how do I treat it
