Schizo

Question 1

Drugs that can cause or worsen psychotic symptoms

7 key drugs

Answer 1

1. Anticholinergics centrally acting, high doses
2. Cannabis
3. Dextromethorphan
4. Dopamine or dopamine agonists, Requip, Mirapex, Sinemet
5. Interferons
6. Stimulants
7. Systemmic roids

Question 2

Positive symptoms of Schizo? 3

Answer 2

1. Hallucinations
2. Delusions
3. Disorganized thinking or behavior

Question 3

What is tardive dyskinesia?

What do you do?

Answer 3

Abnormal facial movements tongue or mouth

Give SGA with low TD risk: Quitiapine, Clozapine

Question 4

Important adverse effects of SGAs?

Highest risk for metabolic SEs? 3

Answer 4

1. Clozapine
2. Olanzapine
3. Quitiapine

Question 5

SGAs that have lower risk of metabolic adverse effects? 4

Answer 5

1. Aripiprazole
2. Ziprasidone
3. Lurasidone
4. Asenapine

Question 6

Lowest risk of EPS SEs for SGAs?

Answer 6

Quitiapine DOC for PD patietns

Question 7

Hemotologic effects of SGAs 1

Answer 7

Highest risk: Clozapine agranulocytosis

Question 8

SGA with highest risk of QT prolongation?

Answer 8

Ziprasidone

Question 9

SGAs that increase prolactin? 2

Answer 9

1. Paliperidone
2. Risperidone

Question 10

SGA with highest risk of seizures?

Answer 10

Clozapine

Question 11

Clozaril?

Answer 11

Clozapine

Question 12

Abilify maintenna?

Answer 12

Aripiprazole IMm give monthly

Question 13

When is clozapine used?

Answer 13

Used no sooner than 3rd line due to adverse effects

Question 14

Lurisidone is what?

Answer 14

Nearly wt, lipid and blood glucose neutral

Question 15

To start clozapine?

Answer 15

ANC must be >= 1500

Stop therapy if ANC is below 1000

Question 16

Risperdal consta?

Answer 16

Risperidone IM injection given every 2 wka

Question 17

Invega sustenna?

Answer 17

Paliperidone

IM given monthly

Question 18

Relprevv?

Answer 18

Olanzapine injection lasts 2-4 wks

Question 19

Invega Trinza?

Answer 19

IM injections given every 3 months start only after getting sustenna for 4 months

Question 20

How is geodon taken?

Answer 20

With food

Question 21

Ingreza?

Answer 21

Valbenazine

Question 22

What is ingrezza used for?

Answer 22

approved for the treatment of TD

Question 23

Common serious SE of FGAs?

Answer 23

Nueroleptic malginant syndrome

Caused by D2 blockade

Question 24

Lithium In Bi polar not easy to initiate

Common SEs 7

Answer 24

1. Nausea
2. Anorexia
3. Abdom pain
4. thirst
5. sedation
6. confusion
7. tremor

Question 25

Drugs that increase risk of serotonin syndrome when taken with lithium? 4

Answer 25

1. SSRI 2. SNRI 3. Triptans 4. Linezolid

Question 26

Suggestions to make lithium easiuer to tolerate? 3 bullets

Answer 26

1. Titrate slowly 2. Take dose at end of meal 3. Drink fluids

Question 27

How to dose lithium?

Answer 27

5 ml lithium = 8 mEq 8 mEq= 300 mg

Question 28

THings that can increase lithium?

Answer 28

Decreased sodium: ACE ARBs NSAIDs

Question 29

Increase neurotoxicity if take with lithium?

Answer 29

1. Verapamil 2. Diltiazem 3. phenytoin 4. Carbamazepine

Question 30

What SGA has the most favorable effects in pregnancy?

Answer 30

Lurasidone

Question 31

Lithium \>1.5 mEq/L SEs? 5

Answer 31

1. Coarse hand tremor 2. Vomiting 3. Persistent diarrhea 4. confusion 5. Ataxia (Impaired coordination)

Question 32

Lithium level \> 2.5 mEq/L SEs? 5

Answer 32

1. CNS depression 2. Arrythmia 3. Seizures 4. Irreversible brain damage 5. coma

Question 33

IV admin of phenytoin?

Answer 33

Filter Dilute in NS and stable for 4 hours

Question 34

Zonisamide SEs? and notes

Answer 34

SEs are similar to topiramate including oligohydrosis/hyperthermia Conta: Hypersensitivy to sulfonamides

Question 35

Zyban

Answer 35

Bupropion

Question 36

Initial Lamictal dosing?

Answer 36

wks 1 and 2 25 mg daily Maintenance: 300-400 mg in divided BID

Question 37

Carbamazepine and Oxcarb cause what?

Answer 37

Hyponatremia

Question 38

SEs of Valproate? 6

Answer 38

Hyperammonia Thrombocytopenia Hepatic failure fetal harm Alopecia Wt gain