SCHIZO

Question 1

What are the symptoms needed to diagnose schizophrenia?

Answer 1

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

Question 2

What is the mechanism of action of action for antipsych meds?

Answer 2

Meds tend to work on the dopamine (DA) 2 receptor antagonist

Question 3

What are the typical antipsych meds?

Answer 3

Question 4

What are the atypical antipsych meds?

Answer 4

Question 5

What is the new 2024 M1/M4 agonist medication?

Answer 5

Xanomeline/Trospium (Cobenfy)

Question 6

What do first generation antipsychotics and conventional antipsychs do that second generations do not?

Answer 6

First generations do not have 5HT2a antagonism but second generations do

Question 7

What does binding to D2 do?

Answer 7

Decreases the positive symptoms of psychosis BUT it you get EPS and hyperprolactemia

Question 8

What does binding to M1 do?

Answer 8

Mitigation of EPS
BUT: ortho hypotension, blurry , dry mouth, sinus tachy

Question 9

What does binding to H1 do?

Answer 9

Therapeutic effect: Sedation
Bad: Drowsiness and weight gain

Question 10

What does binding to alpha 1 do?

Answer 10

Therapeutic effects: we dunno
Bad: Reflex tachy, ortho hypo, dizziness

Question 11

What guidelines do u quote for schizo management?

Answer 11

American Psychiatric (gout) association

Question 11

5HT2A

Answer 11

Serotonin. Antagonism is only present in second generation antipsychotics

Question 12

List some reasons for non adherence to medication

Answer 12

Question 13

List some immediate release IM anti psychotics. When are they used?

Answer 13

Haloperidol + or Olanzapine are common use for acute stabilization

Question 13

What are some non pharmacological approaches to schizo treatment?

Answer 13

Question 13

What do I do when there is acute stabilization/ agitation

Answer 13

Question 14

Should I give IM Olanzapine and IM benzo at the same time?

Answer 14

HELL NO

Question 14

What are the phases of illness?

Answer 14

Question 15

What is Adusave (Inhaled loxapine)?

Answer 15

Question 16

Tell me the mechanism, precautions, adverse effects, and monitoring for sublingual dexmedetomidine.

Answer 16

Question 17

Tell me about Xanomeline/Trospium (Cobenfy). Its ADRs, Drug interactions, Contraindications, and Special considerations

Answer 17

Question 18

List me the drug interaction potentials (predominantly what reacts with cigarettes and what happens?)

Answer 18

Clozapine and Olanzapine

Question 19

Give me the 4 treatment principles from slide 35?

Answer 19

Question 20

What should I keep in mind when selecting an antipscyh med (slide 36)?

Answer 20

Question 21

What is the safety concern for all elderly patients?

Answer 21

Question 22

What are the general differences between FGAs and SGAs

Answer 22

Question 23

Tell me about FGAs and tell me some examples of them

Answer 23

Question 24

Tell me about the atypicals

Answer 24

Question 25

Tell me about ADEs and metabolic syndrome (slide 43)

Answer 25

Common in atypicals

Question 26

Tell me which drugs have the lowest risk vs highest risk for metabolic ADEs of SGAs

Answer 26

Lowest is: Aripiprazole, Ziprasidone, Lurasidone Highest: Clozapine>Olanzapine

Question 27

Compare: SGAs Ariprazole, Risperidone, Paliperidone, Quetiapine

Answer 27

Question 28

Compare SGAs: Olanzapine, Ziprasidone, Lurasidone, Asenapine

Answer 28

Question 28

Tell me about QT prolongation in Antipsych meds and list the lowest risk to highest risk for me.

Answer 28

Lowest: Abilify Highest Ziprasidone, Haloperidol, Thiordazine

Question 29

What do u monitor for FGAs? What do you monitor for SGAs?

Answer 29

Question 29

What do I council for antipsychs?

Answer 29

Question 30

Tell me about Clozapine tolerability and list me its black box warnings.

Answer 30

Not first line, only for treatment resistant schizophrenia

Question 31

Tell me about clozapine's dose initation and titration methodology.

Answer 31

Question 32

Tell me about Clozapine induced seizures

Answer 32

Question 33

What are the adverse effects of clozapine

Answer 33

It is rare to get seizures and that risk comes with rapid titration and serum concentrations over >1000 ng/ml

Question 33

Tell me about clozapine serum concentration monitoring

Answer 33

Goal serum concentration is 350-999 ng/ml

Question 33

Tell me about the clozapine REMs program

Answer 33

Question 34

What are the requirements for Clozapine?

Answer 34

Question 35

Tell me the rationale for long acting injectable antipsychotics (LAIS) medications

Answer 35

Question 36

How do u transition from PO to LAIS?

Answer 36

Question 37

Tell me about LAI formulations and routes of administration.

Answer 37

Question 38

Give me some LAI specifics (Slide68)

Answer 38

DECANOATE IS SESAME OIL IT STICKS LONGER SO ITS ONLY FOR LAI

Question 39

How do you administer LAIs.

Answer 39

Question 40

What happens of ur early, miss or have a late dose?

Answer 40

Question 41

How do i approach antipysch failure

Answer 41

Question 42

What are the principles for switching antipsych meds

Answer 42

Question 43

What are some treatment emergent adverse effects (TEAEs)?

Answer 43

Question 44

What are the types of EPS and how are they treated?

Answer 44

Question 45

What is tardive dyskinesia

Answer 45

Question 46

What is the history in treating tardive dyskinesia

Answer 46

Question 47

What are the new agents used to treat Tardive dyskinesia and how do they work

Answer 47

Question 48

What is the treatment to adverse effect management for tardive medications

Answer 48

Question 49

what is neuroleptic malignant syndrome and how do I treat it

Answer 49