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Therapeutics P3 Fall > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

positive symptoms

A

hallucinations
delusions
ideas of influence
disorganized speech
disconnected thoughts

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2
Q

negative symptoms (4 A’s)

A

flat Affect (no emotional expression)
Alogia (inability to carry a logical conversation)
Anhedonia (inability to experience pleasure)
Avolition (lack of motivation)

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3
Q

cognitive symptoms

A

impaired attention
impaired working memory
impaired executive function

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4
Q

Low potency antipsychotics

A

chlorpromazine
thioridazine

low EPS risk
high anticholinergic risk

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5
Q

High potency antipsychotics

A

fluphenazine
haloperidol

high EPS risk
low anticholinergic risk

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6
Q

Acute dystonia

A

painful prolonged muscle contractions
involuntary buccal, facial, oculogyric movement
may involve back, arms, legs
onset 24-96 hrs after med change

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7
Q

Acute dystonia treatment

A

anticholinergics
IM Benzos
decrease dose or d/c offending agent

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8
Q

Pseudo-parkinsonism

A

bradykinesia
tremor
pill rolling
cogwheel rigidity
postural and oral abnormalities
onset 1-2 weeks post med change

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9
Q

Pseudo-parkinsonism treatments

A

anticholinergics
decrease dose or d/c offending agent

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10
Q

Akathisia

A

restlessness
pacing
shuffling
compulsion to stay in motion
distress
onset hrs-days after med change

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11
Q

Akathisia treatment

A

beta blockers
decrease dose or d/c offending agent

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12
Q

Tardive dyskinesia

A

tongue thrusting, chewing, lip smacking, grimacing, limb twisting, rocking
onset months-years after med change

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13
Q

Tardive dyskinesia reatment

A

prevention
DC offending agent

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14
Q

First Generation Antipsychotics

A

Chlorpromazine (Thorazine)
Fluphenazine (Proxiln)
Haloperidol (Haldol)
Perphenazine (Trilafon)
Thioridazine (Mellaril)
Thiothixene (Navane)

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15
Q

First Generation Antipsychotics ADEs

A

EPS
QTc prolongation
Prolactin elevation
dermatologic
photosensitivity
blue-gray skin (haldol)
orthostatic HTN
altered thermoregulation

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16
Q

Extra-pyramidal symptoms (EPS)

A

involuntary movement
tremors
stiff muscles

17
Q

Antipsychotics available as Long Acting Injections (LAIs)

A

Aripiprazole (Maintena, Aristada)
Olanzapine (Zyprexa)
Paliperidone (Sustenna, Trinsa)
Risperidone (Consta IM) (Perseris SQ)
Fluphenazine
Haloperidol

18
Q

Aripiprazole (Abilify)

A

impulsivity
2nd gen
little weight gain
less sedating
may cause insomnia, akathisia, restlessness

19
Q

Asenapine (Saphris)

A

topical patch available
2nd gen
among the least sedating and anticholinergic
high risk for QT prolongation
anaphylaxis may occur after a single dose
CI: severe hepatic disease

20
Q

Brexpiprazole (Rexulti)

A

impulsivity
2nd gen
akathisia
long t1/2
fewer metabolic effects

21
Q

Clozapine (Clozaril, Fazaclo)

A

Blood dyscrasia, metabolic risk
2nd gen
gold standard for refractory illness (suicidality)
QTc prolongation
seizure
myocarditis
MUST BE PRESCRIBED A BOWEL REGIMEN
REMS program

22
Q

Iloperidone (Fanapt)

A

orthostatic hypotension, slow titration needed
2nd gen
no notable prolactin inc
QTc warnings
less sedating
caution in hepatic impairment

23
Q

Lurasidone (Latuda)

A

do not use with strong CYP3A4 inhibitor/inducor
2nd gen
no notable prolactin inc
less sedation
approved for adolescent use
depression associated with bipolar disorder as monotherapy or adjunct with lithium or valproate

24
Q

Lumateperone (Caplyta)

A

2nd gen
well tolerated
somnolence
sedation
fatigue
constipation

25
Q

olanzapine (Zyprexa)

A

metabolic risks, DRESS
2nd gen
post injection delirium/sedation -> REMS for LAI
sedating
QTc
ANC

26
Q

Paliperidone (Invega)

A

EPS, Prolactin
2nd gen
no PO overlap required
must be maintained on Sustenna for at least 4 months before Trinza

27
Q

Pimavanserin (Nuplazid)

A

no dopamine
2nd gen
indicated for treatment of hallucinations and delusions associated with Parkinson’s disease psychosis
QTc warnings

28
Q

Quetiapine (Seroquel)

A

sedation, anticholinergic effects cataracts
2nd gen
may be misused as sleep aid

29
Q

Risperidone (Risperdal)

A

EPS, prolactin
2nd gen
Aqueous injection for IM admin

30
Q

Ziprasidone (Geodon)

A

contraindicated in pats with high risk of QTc prolongation
2nd gen
DRESS

31
Q

Anticholinergic effects

A

dry mouth
blurry vision
sedation
constipation
hallucinations
memory problems

32
Q

General Second Generation Antipsychotic ADEs

A

Metabolic syndrome
- hypertriglyceridemia
- hyperglycemia
- weight gain
QTc prolongation
blood dyscrasia
dec seizure threshold
anticholinergic effects
sedation
prolactin elevation
ophthalmic effects

Therapeutics P3 Fall (21 decks)

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