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pr 3153 > schizophrenia > Flashcards

schizophrenia Flashcards

1
Q

how does blockage of dopamine receptors mesolimbic tract affect?

A

dopamine blockade prevents overactivity responsible for positive symptoms

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2
Q

how does blockage of dopamine receptors in mesocortical tract affect

A

hypofunction results in negative unwanted sx

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3
Q

how does blockage of dopamine receptors in nigrostriatal tract affect

A

blockade causes epse

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4
Q

how does blockage of dopamine receptors in tuberinfundibular tract affect

A

dopamine blockade leads to hyperprolactinemia

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5
Q

therapeutic effects of D2 antagonism

A

reduces positive sx

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6
Q

side effects of D2 antagonism

A

epse, hyperprolactinemia

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7
Q

therapeutic effects of 5HT1A agonism

A

anxiolytic properties

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8
Q

therapeutic effects of 5HT2A antagonism

A

antidepressant effects, improve negative sx

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9
Q

side effects of 5HT2C antagonism

A

weight gain

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10
Q

side effects of H1 antagonism

A

sedation / weight gain

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11
Q

side effects of alpha 1 antagonism

A

orthostasis

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12
Q

side effects of m1 antagonism

A

anticholinergic effects (acute urinary retention, delirium)

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13
Q

side effects of IKR antagonism

A

QTc interval prolongation

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14
Q

clozapine monitoring

A

weekly WBC and ANC count for first 18 weeks, then monthly

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15
Q

why avoid in elderly with dementia

A

increased risks for mortality and stroke

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16
Q

if patient is uncooperative during acute agitation

A

IM lorazepam, olanzapine, haloperidol, promethazine

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17
Q

if patient is cooperative during acute agitation

A

PO Lorazepam, PO risperidone

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18
Q

NMS symptoms (antipsychotics)

A

muscle rigidity, fever, autonomic dysfunction, altered consciousness, increased serum creatine kinase

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19
Q

ortho hypot: which drug has the lowest risk

A

aripripazole

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20
Q

ortho hypo t: does olan or quet have higher risk?

A

quet

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21
Q

ortho hypo t: does risp or pali have higher risk?

A

risp,pali, quet same

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22
Q

ortho hypo t: does cloz or risp have higher risk?

A

cloz

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23
Q

ortho hypot: which drug has the highest risk

A

chlorpromazine

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24
Q

what drugs have risk of vte

A

low potency fga

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25
Q

qtc prolong: which drug has higher risk (olan/quet)

A

quet.

olan has the lowest risk

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26
Q

qtc prolong: which drug has higher risk (halo/cpz)

A

cpz

27
Q

qtc prolong: which drug has higher risk (quet/risp)

A

quet

28
Q

qtc prolong: which drug has the highest risk

A

thioridazine

29
Q

drugs causing neuroleptic malignant syndrome

A

high potency antipsychotics

30
Q

antidote for nms

A

IV dantrolene, PO dopamine agonist

31
Q

clozapine adverse effects

A

decrease in wbc count, agranulocytosis (blood dyscrasias)

32
Q

what to monitor

A

BMI, fasting sugar, lipids, blood pressure, EPSE exam

33
Q

elderly what to avoid

A

drugs causing alpha1 adrenergic blockade, anticholinergic side effects

34
Q

2d6 inhibitors

A

fluoxetine, paroxetine, bupropion

35
Q

3a4 inducers

A

simvastatin, lovastatin, nifedipine, amlodipine, diltiazem, phenytoin, cbz

36
Q

fluvoxamine pd characteristics

A

1a2 inhibitor, 2c19 inhibitor

37
Q

substrates of 2d6

A

metoprolol, codeine, hydrocodone, oxycodone, tramadol

38
Q

substrates of 1a2

A

amiodarone, theophylline, warfarin

39
Q

clozapine interactions

A

(1a2 inhibitors) fluvox, quionlones, macrolides, isoniaid, ketoconazole
(agranulocytosis) cbz

40
Q

contraindication to antipsych

A

qtc prolongation

41
Q

precautions of antipsychs

A

cvs
parkinson’s disease
prostatic hypertrophy
angle closure glaucoma

42
Q

what to avoid with IM olanzapine

A

use of IM lorazepam

43
Q

low potency antipsychs

A

clozapine, chlorpromazine, quetiapine

44
Q

high potency antipsychs

A

haloperidol, olanzapine, risperidone

45
Q

side effects of antipsychs

A

dystonia,
pseudo-parkinsonism, akathisia (restlessness),
tardive dyskinesia, hyperprolactinemia, metabolic
orthostatic hypoT
NMS (muscle rigidity, fever)

46
Q

monitoring for sga

A

bmi,
fasting blood glucose,
lipid panel,
blood pressure,
epse exam

47
Q

to reverse epse effects

A

IM benztropine (antichol)

48
Q

to mitigate akathisia (restlessness)

A

clonazepam, propanolol

49
Q

to reverse tardive dyskinesia

A

discontinue anticholinergics

50
Q

drugs should be given IM or IV

A

IM, prevent bp crashing

51
Q

sedation higher (cpz/cloz)

A

cpz. it has the highest risk of sedation.

52
Q

sedation (risp/cloz)

A

cloz

53
Q

sedation (risp/olan)

A

olan

54
Q

sedation (quet/cloz)

A

cloz

55
Q

sedation (quet/risp)

A

quet

56
Q

sedation (pali/quet)

A

quet

57
Q

seizure (cloz/sga/cpz)

A

cloz/cpz > sga

58
Q

which drugs cause raised lfts

A

cpz and other fga, olan, quet

59
Q

haloperidol/olanzapine a substrate of?

A

1a2, 2d6

60
Q

risp a substrate of ?

A

2d6, 3a4

61
Q

quetiapine a substrate of?

A

3a4

62
Q

aripiprazole a substrate of?

A

2d6, 3a4

63
Q

clozapine a substrate of?

A

1a2

64
Q

side effect of blockage of post synaptic receptor

A

epse

pr 3153 (8 decks)

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