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Neuro > Schizo > Flashcards

Schizo Flashcards

1
Q

Criteria to diagnose Schizophrenia….

A

A. 2+ of these symptoms, one must be 1,2,or 3:
Delusions, Hallucinations, Diorganized speech
Unorganized or catatonic behavior, Negative symptoms

B. FUNCTIONALITY DECREASED IN SOME ASPECT OF THEIR LIFE

C. 6 MONTHS OF SYMPTOMS W/1 MONTH OF SYMPTOMS

D. RULE OUT SHIZOEFFECTIVE DX, DEPRESSIVE/BIPOLAR DX, AND SUBSTANCE!!!

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2
Q

Brain part demonstrated differnent in Schizo…

A

Large Lateral Ventricles

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3
Q

Mainstay of NONDRUG Tx for Schizo….

A

Psychosocial Rehab Programs

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4
Q

1st Line Pharm Treatment…

A

Second Gen Antipsychotics (ATYPICALS)

  • Aripriprazole (Abilify)
  • Ziprasidone (geodon)
  • Risperidone (Risperidal)
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5
Q

Aripiprazole

A

Abilify

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6
Q

Ziprasidone

A

Geodon

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7
Q

Risperidone

A

Risperdal

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8
Q

What 3rd line agent is good if pt is suicidal…

A

Clozapine

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9
Q

Second Gen Antipsychotics

A
  • APINES
  • IDONE
  • PIPRAZOLE
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10
Q

Clozapine brand name and important adverse effect….

A

CLozaril

Neutropenia (agranulocytosis)

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11
Q

Clozapine WORST SE….

A

Seizures
Anticholinergic
Orthostatis
Metabolic (wt, glucose, lipids)

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12
Q

Clozapine is least for giving this side effect….

A

EPS…may be used to treat TD

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13
Q

Least SGA for Wt gain and QT prolongation

A

Aripripazole (Abilify)

Lurasidone (Latuda)

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14
Q

WORST SGA for EPS and Hyperprolactinemia

A

Paliperidone (Invega)

Risperidone (Risperdal)

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15
Q

Worst SGA for Metabolic (wt,lipids,glucose)….

A

Olanzapine

Clonazapine

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16
Q

Ziprasidone is worst SGA for…

A

QT prolongation

17
Q

Asenapine comes in unique dosage forms…

A

Sublingual-SAPHRIS

Transdermal Patch-SECUADO approved 10/2019

18
Q

Clozapine comes in unique dosage forms…

A

Sublingual-FAZACLO ODT

Oral suspension-VERSACLOZ

19
Q

Loxitane is a FGA with unique dosing forms….

A

Inhaled-ADASUVE

20
Q

Antipsychotics LONG ACTING INJECTABLES

A

Olanzapine
Risperidone
Paliperidone

21
Q

Abilify is associated with what kind of problems?

A

Impulse control disorders like gambling, sexual urges, and uncontrolled spending or eating

22
Q

Possible Mood Stabilizers to add on…

A

Carbamazepine
Valproate
Lithium helps with agitation
Lamotrigine

23
Q

Antidepressants may help improve….

A

Negative Sysmptoms

Use Mirtazapine

24
Q

Olanzapine Brand and Injection info

A

Zyprexa
REMS Program
Post-injection delirium/sedation syndrome, monitor for this, symptoms are similar to a PO overdose and include delirium, ataxis, confusion, heavy sedation, or altered level of consciousness

25
Q

Paliperidone Palmitate Brand and Injection information

A

IVEGA TRINZA/3MPP
LONGEST DOSING INTERVAL
Treat w/IVEGA SUSTENNA 4 months prior to starting TRINZA

26
Q

Risperidone Brand and injection info

A

PERSERIS

SQ Abdomen

27
Q

Acute Dystonia

Definition, TOC

A

Abnormal tonicity-Sever muscle spasms, usually head + neck, 1-4 days of initiation

IM or IV Anticholinergics, BENZOS 2nd line
Benadryl 15-50mg IM
Benztropine (Cogentin) 1-2mg IM

28
Q

Pseudoparkisonism

Info, TOC

A

Resembles Parkinson’s: Gait disturbences, Cogwheel rigidity, 1-3 months of initiation

Decrease Dose + Anticholinergic
Benztropine 4-10mg
Diphenhydramine 50-200mg
Trihexphenidyl (Artane) 4-20mg
Amantadine 100-400mg
29
Q

Deutetrabenezine

A

AUSTEDO

New med to treat Tardive Dyskinisia
BBW: DEPRESSION AND SUICIDAL IDEATION

30
Q

Tardive Dyskinesia

Info and TOC

A

Insidious onset (late) oral and orofacial movements smacking or tongue thrusting

CAN BE IRREVERSIBLE
Prevention is key: Minimum effective dose, Atypical meds

TOC: Deutrabenezine (AUSTEDO)
Velbenazine (INGREZZA)

31
Q

Valbenazine

A

INGREZZA

New med to treat TD
Also has warnings for suicidality, depression, QT prolongation

32
Q

Akathisia

Info and TOC

A

Inner Restlessness-JITTERS, subjectively reported but can be observed

Can lead to TD if not treated*

COMMONLY CAUSED BY TOO FAST OF A TITRATION OF MEDICATION

Decrease dose or change agent
Propranolol (INDERAL) 30-120mg qd
Lorazepam (Ativan) 0.5-10mg

33
Q

Seizure are associated with these meds because…

A

They decreased the seizure threshold, increasing risk of drug induced seizures

Closely associated with High plasma conc, Rapid titration, Initiation of tx

34
Q

Highest Antipsychotics with Seizure possibility…

A

Clozapine

Chlorpromazine

35
Q

Lowest Seizure possibility…

A 
Aripiprazole
Risperidone
Haloperidol
Thioridazine
Trifluoperazine
Fluphenazine
36
Q

QT Prolongation…

A

Caution with other Qt prolonging agents, QTc near 500

Get a baseline ECG

37
Q

Most at risk for QT prolongation…

A

Ziprasidone
Thioridazine
Iloperidone

38
Q

LEAST at risk for QT prolongation…

A

Aripiprazole

Lurasidone

39
Q

Pregnancy…

A

Concerned with movement disorders and withdrawal following birth

Maybe switch to med with less risk…
CLOZAPINE AND LURASIDONE BOTH CLASS B

NO BREAST FEEDING

Neuro (12 decks)

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