Schizo Flashcards
Drugs that can cause or worsen psychotic symptoms
7 key drugs
- Anticholinergics centrally acting, high doses
- Cannabis
- Dextromethorphan
- Dopamine or dopamine agonists, Requip, Mirapex, Sinemet
- Interferons
- Stimulants
- Systemmic roids
Positive symptoms of Schizo? 3
- Hallucinations
- Delusions
- Disorganized thinking or behavior
What is tardive dyskinesia?
What do you do?
Abnormal facial movements tongue or mouth
Give SGA with low TD risk: Quitiapine, Clozapine
Important adverse effects of SGAs?
Highest risk for metabolic SEs? 3
- Clozapine
- Olanzapine
- Quitiapine
SGAs that have lower risk of metabolic adverse effects? 4
- Aripiprazole
- Ziprasidone
- Lurasidone
- Asenapine
Lowest risk of EPS SEs for SGAs?
Quitiapine DOC for PD patietns
Hemotologic effects of SGAs 1
Highest risk: Clozapine agranulocytosis
SGA with highest risk of QT prolongation?
Ziprasidone
SGAs that increase prolactin? 2
- Paliperidone
- Risperidone
SGA with highest risk of seizures?
Clozapine
Clozaril?
Clozapine
Abilify maintenna?
Aripiprazole IMm give monthly
When is clozapine used?
Used no sooner than 3rd line due to adverse effects
Lurisidone is what?
Nearly wt, lipid and blood glucose neutral
To start clozapine?
ANC must be >= 1500
Stop therapy if ANC is below 1000
Risperdal consta?
Risperidone IM injection given every 2 wka
Invega sustenna?
Paliperidone
IM given monthly
Relprevv?
Olanzapine injection lasts 2-4 wks
Invega Trinza?
IM injections given every 3 months start only after getting sustenna for 4 months
How is geodon taken?
With food
Ingreza?
Valbenazine
What is ingrezza used for?
approved for the treatment of TD
Common serious SE of FGAs?
Nueroleptic malginant syndrome
Caused by D2 blockade
Lithium In Bi polar not easy to initiate
Common SEs 7
- Nausea
- Anorexia
- Abdom pain
- thirst
- sedation
- confusion
- tremor
Drugs that increase risk of serotonin syndrome when taken with lithium? 4
- SSRI
- SNRI
- Triptans
- Linezolid
Suggestions to make lithium easiuer to tolerate? 3 bullets
- Titrate slowly
- Take dose at end of meal
- Drink fluids
How to dose lithium?
5 ml lithium = 8 mEq
8 mEq= 300 mg
THings that can increase lithium?
Decreased sodium: ACE ARBs
NSAIDs
Increase neurotoxicity if take with lithium?
- Verapamil
- Diltiazem
- phenytoin
- Carbamazepine
What SGA has the most favorable effects in pregnancy?
Lurasidone
Lithium >1.5 mEq/L SEs? 5
- Coarse hand tremor
- Vomiting
- Persistent diarrhea
- confusion
- Ataxia (Impaired coordination)
Lithium level > 2.5 mEq/L SEs? 5
- CNS depression
- Arrythmia
- Seizures
- Irreversible brain damage
- coma
IV admin of phenytoin?
Filter
Dilute in NS and stable for 4 hours
Zonisamide SEs? and notes
SEs are similar to topiramate including oligohydrosis/hyperthermia
Conta: Hypersensitivy to sulfonamides
Zyban
Bupropion
Initial Lamictal dosing?
wks 1 and 2 25 mg daily
Maintenance: 300-400 mg in divided BID
Carbamazepine and Oxcarb cause what?
Hyponatremia
SEs of Valproate? 6
Hyperammonia
Thrombocytopenia
Hepatic failure fetal harm
Alopecia
Wt gain