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Schizo Flashcards

1
Q

Drugs that can cause or worsen psychotic symptoms

7 key drugs

A
  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
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2
Q

Positive symptoms of Schizo? 3

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

What is tardive dyskinesia?

What do you do?

A

Abnormal facial movements tongue or mouth

Give SGA with low TD risk: Quitiapine, Clozapine

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4
Q

Important adverse effects of SGAs?

Highest risk for metabolic SEs? 3

A
  1. Clozapine
  2. Olanzapine
  3. Quitiapine
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5
Q

SGAs that have lower risk of metabolic adverse effects? 4

A
  1. Aripiprazole
  2. Ziprasidone
  3. Lurasidone
  4. Asenapine
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6
Q

Lowest risk of EPS SEs for SGAs?

A

Quitiapine DOC for PD patietns

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7
Q

Hemotologic effects of SGAs 1

A

Highest risk: Clozapine agranulocytosis

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8
Q

SGA with highest risk of QT prolongation?

A

Ziprasidone

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9
Q

SGAs that increase prolactin? 2

A
  1. Paliperidone
  2. Risperidone
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10
Q

SGA with highest risk of seizures?

A

Clozapine

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11
Q

Clozaril?

A

Clozapine

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12
Q

Abilify maintenna?

A

Aripiprazole IMm give monthly

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13
Q

When is clozapine used?

A

Used no sooner than 3rd line due to adverse effects

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14
Q

Lurisidone is what?

A

Nearly wt, lipid and blood glucose neutral

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15
Q

To start clozapine?

A

ANC must be >= 1500

Stop therapy if ANC is below 1000

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16
Q

Risperdal consta?

A

Risperidone IM injection given every 2 wka

17
Q

Invega sustenna?

A

Paliperidone

IM given monthly

18
Q

Relprevv?

A

Olanzapine injection lasts 2-4 wks

19
Q

Invega Trinza?

A

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

20
Q

How is geodon taken?

21
Q

Ingreza?

A

Valbenazine

22
Q

What is ingrezza used for?

A

approved for the treatment of TD

23
Q

Common serious SE of FGAs?

A

Nueroleptic malginant syndrome

Caused by D2 blockade

24
Q

Lithium In Bi polar not easy to initiate

Common SEs 7

A
  1. Nausea
  2. Anorexia
  3. Abdom pain
  4. thirst
  5. sedation
  6. confusion
  7. tremor
25
Q

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

A
  1. SSRI
  2. SNRI
  3. Triptans
  4. Linezolid
26
Q

Suggestions to make lithium easiuer to tolerate? 3 bullets

A
  1. Titrate slowly
  2. Take dose at end of meal
  3. Drink fluids
27
Q

How to dose lithium?

A

5 ml lithium = 8 mEq

8 mEq= 300 mg

28
Q

THings that can increase lithium?

A

Decreased sodium: ACE ARBs

NSAIDs

29
Q

Increase neurotoxicity if take with lithium?

A
  1. Verapamil
  2. Diltiazem
  3. phenytoin
  4. Carbamazepine
30
Q

What SGA has the most favorable effects in pregnancy?

A

Lurasidone

31
Q

Lithium >1.5 mEq/L SEs? 5

A
  1. Coarse hand tremor
  2. Vomiting
  3. Persistent diarrhea
  4. confusion
  5. Ataxia (Impaired coordination)
32
Q

Lithium level > 2.5 mEq/L SEs? 5

A
  1. CNS depression
  2. Arrythmia
  3. Seizures
  4. Irreversible brain damage
  5. coma
33
Q

IV admin of phenytoin?

A

Filter

Dilute in NS and stable for 4 hours

34
Q

Zonisamide SEs? and notes

A

SEs are similar to topiramate including oligohydrosis/hyperthermia

Conta: Hypersensitivy to sulfonamides

35
Q

Zyban

36
Q

Initial Lamictal dosing?

A

wks 1 and 2 25 mg daily

Maintenance: 300-400 mg in divided BID

37
Q

Carbamazepine and Oxcarb cause what?

A

Hyponatremia

38
Q

SEs of Valproate? 6

A

Hyperammonia

Thrombocytopenia

Hepatic failure fetal harm

Alopecia

Wt gain

NAPLEX (64 decks)

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