Schizophrenia Flashcards
1
Q
Schizophrenia abnormalities in what 5 domains
A
delusions hallucinations disorganized thinking and speech grossly disorganized and abnoraml motor behavior negative symptoms
2
Q
schizophrenia is more common in what gender
A
equal
3
Q
onset on schizophrenia
A
men - early 20s
women late 20s to early 30s
4
Q
positive symptoms of schizophrenia
A
hallucinations delusions disorganized speech unusual behavior combativeness and agitation
5
Q
negative symptoms of schizophrenia
A
blunted affect alogia anhedonia avolition asociality loss of emotional connectedness
6
Q
define alogia
A
no spontaneous talking
7
Q
define anhedonia
A
inability to experience pleasure
8
Q
define avoloition
A
lack of drive
9
Q
cognitive impairments seen in schizophrenia
A
impaired attention
impaired working memory
impaired executive function
10
Q
features associated with schizophrenia
A
inappropriate affect dysphoric mood (depression, anger, anxiety) disturbed sleep pattern lack of interest in food anosognosia hostility and aggression
11
Q
define anosognosia
A
lack insight or awareness of disorder
12
Q
to be diagnosed schizophrenic a patient must have 2+ or these for at least 1 month
A
delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms
13
Q
to be diagnosed with schizophrenia how long must symptoms be present
A
6 months
14
Q
define catatonia
A
marked psychomotor disturbance that may involve decreased motor activity, depressed engagement during interview or exam, or excessive and peculiar motor activity
15
Q
catatonia is 3+ of the following symptosm
A
stupor catalepsy waxy flexibility mutism negativism posturing mannerism stereotypy agitation grimacing echolalia echopraxia
16
Q
other psychiatric illness to rule out for diagnosis of schizophrenia
A
major depression schizoaffective disorder brief reactive psychosis schizophreniform disorder delusional disorder induced psychotic disorder panic disorder depersonalization disorder OCD personality disorders factitious disorders malingering
17
Q
general medical illnesses to rule out for schizophrenia
A
temporal lobe epilepsy tumor, stroke, brain trauma endocrine/metabolic disorders B12 deficiency infections (neurosyphallis) autoimmune toxins (heavy metal poisining)
18
Q
Drugs to rule out for schizophrenia
A
stimulants hallucinogens anticholingerics alcohol withdrawal barbituate withdrawal phencyclidine ketamine
19
Q
black box warning on all atypical antipsychotics
A
increased mortality with dementia related psychosis
20
Q
What is the principle difference between typical and atypical antipsychotics
A
type and severity of AEs including antihistaminic, antiserotoninergic, anti dopaminergic, anticholinergic, anti alpha 1 adrenergic
21
Q
typical or atypical: aripiprazole
A
atypical
22
Q
typical or atypical: asenapine
A
atypical
23
Q
typical or atypical: clozapine
A
atypical
24
Q
typical or atypical: iloperidone
A
atypical
25
typical or atypical: lurasidone
atypical
26
typical or atypical: olanzapine
atypical
27
typical or atypical: paliperidone
atypical
28
typical or atypical: quetiapine
atypical
29
typical or atypical: risperidone
atypical
30
typical or atypical: ziprasidone
atypical
31
aripiprazole brand name
abilify
32
asenapine brand name
saphris
33
clozapine brand name
clozaril
| fazaclo
34
iloperidone brand name
fanapt
35
lurasidone brand name
latuda
36
olanzipine brand name
zyprexa
zydus
relprevv
37
paliperidone brand name
invega
38
quetiapine brand name
seroquel
39
risperidone brand name
risperdal
40
ziprasidone brand name
geodon
41
All typical antipsychotics pregnancy category
C
42
typical or atypical: chlorpromazine
typical
43
typical or atypical: fluphenazine
typical
44
typical or atypical: thioridazine
typical
45
typical or atypical: perphenazine
typical
46
typical or atypical: trifluoperazine
typical
47
typical or atypical: haloperidol
typical
48
typical or atypical: pimozide
typical
49
typical or atypical: thiothixene
typical
50
chlorpromazine brand name
thorazine
51
fluphenazine brand name
prolixin
52
thioidazine brand name
mellaril
53
perphenazine brand name
trilafon
54
trifluoperazine brand name
stelazine
55
haloperidol brand name
haldol
56
pimozide brand name
orap
57
thiothixene brand name
navane
58
usual dosage range of aripirazole
15-30 mg /day
59
max dosage of aripiprazole
30 mg/day
60
usual dosage range of olanzepine
15-20 mg/day
61
max dosage of olanzepine
30-40 mg/day (manufacturer says 20)
62
usual dosage range of quetiapine
300-800 mg/day
63
max dosage of quetiapine
800 mg/day (see 1000-1200 in practice)
64
usual dosage of risperidone
3-6mg/day
65
max dosage of risperidone
6-8 mg/day
66
usual dosage of ziprasidone
100-120 mg/day
67
max dosage of ziprasidone
160-240 (200)
68
starting dose of aripiprazole and frequency
10-15 mg/day given once daily
69
AEs of aripiprazole
```
headache
dizziness
weight gain
agitation
anxiety
insomnia
somnolence
```
70
aripiprazole pregnancy category
C
71
Drug interactions with aripiprazole
```
metoclopropamide
fluoxetine/paroxetine
quinidine
carbamazepine
valproic acid
```
72
Aripiprazole shouldn't be given with this medicaiton
metoclopropamide
73
aripiprazole dose should be decreased 50% with this medication/s
fluoxetine
paroxetine
quinidine
74
apriprazole dose should be doubled with this medication
carbamazepine
75
ariprazole dosage forms
PO or IM
76
aripriprazole frequency
QD or Q month (IM)
77
A poor CYP 2D6 metabolizer should get what dose of abilify maintena
300 mg
78
what is the normal dose of abilify maintena
400 mg
79
what is the dose of abilify maintena for a cyp2D6 poor metabolizer taking CYP3A4 inhibitors
200 mg
80
What is the dose of abilify maintena for those taking 400 mg normally on stong cyp 2D6 or cyp 3A4 inhibitors for > 14 days
300 mg
81
What is the dose of abilify maintena for those taking 400 mg normally on stong cyp 2D6 AND cyp 3A4 inhibitors for > 14 days
200 mg
82
What is the dose of abilify maintena for those taking 400 mg normally on stong cyp 3A4 inducers for > 14 days
Avoid use
83
What is the dose of abilify maintena for those taking 300 mg normally on stong cyp 2D6 or cyp 3A4 inhibitors for > 14 days
200 mg
84
What is the dose of abilify maintena for those taking 400 mg normally on stong cyp 2D6 and cyp 3A4 inhibitors for > 14 days
160 mg
85
What is the dose of abilify maintena for those taking 400 mg normally on stong cyp 3A4 inducers for > 14 days
avoid use
86
how does aripiprazole interact with metoclopropamide
increased risk f EPS
87
how does aripiprazole interact with fluoxetine/paroxetine
increased aripiprazole concentration
88
how does aripiprazole interact with quinidine
increased aripiprazole concentration
89
how does aripiprazole interact with carbamazepine
increased aripiprazole clearance
90
how does aripiprazole interact with valproic acid
decreased aripiprazole concentration
91
How to calculate ANC
total WBC * (% neutrophils + % bands) /100
92
Asenapine dose for schizophrenia
5 mg BID
93
Asenapine dosage form
sublingual!
94
AEs of asenapine
weight gain, hyperglycemia, EPS, insomnia, somnolence, orthostatic hypotension, prolonged QTC, HA, dizziness, increased triglycerides/cholesterol, increased prolactin levels, increased LFTs
95
Asenapine pregnancy category
C
96
Drugs to avoid with asenapine
```
Quinolone antibiotics
Phenothiazines
TCAs
Pimozide
Class IA and III antiarhytmics
Quetiapine
Haloperidol
Risperidone
Ziprasidone
```
97
Why avoid drugs with asenapine
increased QTC
98
Clozapine dose
12.5 BID increased gradually by 25-50 mg to 300 mg by day 14.
99
Clozapine max dose
900 mg /day
100
Black box warning with clozapine
agranulocytosis
myocarditis
seizures
101
AEs with clozapine
```
drowsiness, dizziness
hypersalivation
orthostatic hypotension
tachycardia
hyperglycemia
weight gain
increased triglycerides/cholesterol
constipation
```
102
clozapine pregnancy cat
B
103
Clozapine interaction with benzos
delirium, sedation
| resp. collapse
104
clozapine interaction with smoking
decreased clozapine concentration
105
clozapine interaction with carbamazepine
increased risk of bone marrow depression
106
What medications should be avoided with clozapine
carbamazepine
ritonavir
tramadol
107
clozapine interaction with ritonavir
increased clozapine concentration
108
clozapine interaction with tramadol
increased risk of seizure
109
How often is CBC drawn with clozapine
QW x 6 months,
QOW for months 7-12,
1 QM after 12 months,
QW x 1 month after d/c
110
Risk factors for agranulocytosis with clozapine
female,
40+
low initial WBC
111
signs/symptoms of agranulocytosis
```
malaise
fatigue
fever/chills
arthralgias
myalgias
```
112
Iloperidone dose
1 mg BID day 1, 2 mg BID day 2, 4 mg BID day 3, 6 mg BID day 4, target dose of 12-24 mg BID
113
AEs of iloperidone
```
dizziness,
dry mouth
nasal congestion
orthostatic hypotension
weight gain
tachycardia
hyperglycemia
increased prolactin levels
neutropenia/leucopenai
```
114
which medications should be avoided with iloperidone
class 1A and II antiarrhythmics
quinolone antibiotics
phenothiazine antipsychotics
115
Iloperidone pregnancy cat
c
116
Lurasidone dose
40 mg QD w/food.
117
lurasidone max dose
80 mg/day
118
Lurasidone pregnancy cat
B
119
AEs of lurasidone
```
somnolence
akathisia
nausea
parkinsonism
agitation
```
120
lurasidone should be avoided with what medications
ketoconazole
| rifampin
121
lurasidone interaction with ketoconazole
increased lurasidone levels
122
lurasidone interaction with rifampin
decreased lurasidone levels
123
Olanzapine dose
5-10 mg initially. target 10 mg/day up to 30-40 mg/day
124
long acting injection of olanzipine brand name
relprevv
125
dosing of relprevv for the first 8 weeks if the target oral dose is 10 mg
210 mg Q2 weeks or 405 mgQ4 weeks
126
dosing of relprevv for the first 8 weeks if the target oral dose is 15mg
300 mg Q 2 week
127
dosing of relprevv for the first 8 weeks if the target oral dose is 20 mg
300 mg Q 2 weeks
128
dosing of relprevv for the after 8 weeks if the target oral dose is 10 mg
150 mg Q 2 weeks or 300 mg Q 4 weeks
129
dosing of relprevv for the after 8 weeks if the target oral dose is 15 mg
210 Q 2 weeks or 405 Q 4 weeks
130
dosing of relprevv for the after 8 weeks if the target oral dose is 20 mg
300 mg Q 2 weeks
131
AEs of olanzipine
sedation, weight gain, dry mouth, increased LFTs,
| orthostatic hypotension, hyperglycemia, increased triglycerides/cholesterol, increased prolactin, tachycardia
132
olanzipine pregnancy cat
C
133
olanzepine interaction with smoking
decreased olanzepine concentration -> adjust dose
134
olanzepine interaction with caffeine
inreased olanzepine concentration -> may require dec. dose
135
olanzepine should be avoided with what medications
alcohol, benzos, clomipramine
136
olanzepine interaction with clomipramine
increased risk of seizures
137
olanzepine interaction with alcohol/benzo
orthostatic hypotension
138
paliperidone is the active metabolite of what
risperidone
139
paliperidone AEs
sedation, dizziness, increased prolactin, hyperglycemia, weight gain
140
Paliperidone preg cat
C
141
Paliperidone dose
6 mg PO QD
142
paliperidone dose in moderate renal impairment
3 mg PO QD
143
paliperidone max dose
12 mg QD
144
Invega Sustenna is injected where
deltoid/glute
145
Invega sustenna dose if on 3 mg daily oral
39-78 mg
146
Invega sustenna dose if on 6 mg daily oral
117 mg
147
Invega sustenna dose if on 12 mg daily oral
234 mg
148
How often is invega sustenna injected
Q4 weeks
149
Avoid paliperidone with what drugs
Class 1A, III anti arrhythmics
| Quinolone antibiotics
150
Why avoid paliperidone with other drugs
increased QTC
151
Risperidone dose
0.5 mg BID to 3 mg BID
152
AEs of risperidone
sedation, dizziness, tachycardia, sexual dysfunction, rhinitis, nausea, menstrual disturbances, weight gain, hyperglycemia, increased prolactin levels
153
Risperidone interaction with antihypertensives
inceased orthostasis -> monitor BP
154
Risperidone preg. Cat
C
155
Risperidone consta starting dose
25 mg Q 2 weeks
156
risperidone consta oral supplementation is given how long
first 3 weeks
157
Where is risperidone consta injected
IM upper outer gluteal quadrant
158
Quetiapine IR dose
```
25 mg BID day 1
50 mg BID day 2
100 mg BID day 3
100 mg AM + 200 mg PM day 4
increase up to 800 mg/day as needed
```
159
Quetiapine ER dose
300 mg QD in evening up to 400-800 /day
160
AEs of quetiapine
somnolence, agitation, weight gain, dizziness, orthostatic hypotension, increased triglycerides, hyperglycemia
161
quetiapine preg cat
C
162
Quetiapine drug interactions
3A4 inhibitors (ketoconazole, erythromycin)
163
Ziprasidone dose
20 mg BID to 80 BID
164
ziprasidone dose IM for acute psychotic agitation
10 mg @ 2 hour intervals or 20 mg @ 4 hour intervals
165
max ziprasidone IM dose
40 mg
166
Ziprasidone effect on weight
neutral
167
ziprasidone effect on prolactin levels
none
168
AEs of ziprasidone
dyspepsia, constipation, nausea, abdominal pain, increase QTC, hyperglycemia
169
Ziprasidone drugs to avoid
```
quinolone antibiotics
macrolide antibiotics
azole antifungals
TCA
Phenothiazines
Clindamycin
Class 1A, III antiarrhythmics
```
170
Why avoid drugs with ziprasidone
increased QTC
171
Ziprasidone preg Cat
C
172
Which atypical antipsychotics cause the most sedation
clozapine
| lurasidone, olanzapine, quetiapine
173
Which atypical antipsychotics cause the most EPS
paliperidone, risperidone, ziprasidone
174
Which atypical antipsychotics cause the most anticholinergic effect
clozapine, iloperidone
175
Which atypical antipsychotics cause the least anticholinergic effects
aripiprazole, asenapine, ziprasidone
176
Which atypical antipsychotics cause the most orthostasis
clozapine, iloperidone
177
which atypical antipsychotics cause the least orthostasis
aripiprazole, ziprasidone
178
which atypical antipsychotics cause the most weight gain
clozapine, olanzapine
179
which atypical antipsychotics cause the least weight gain
aripiprazole, lurasidone, ziprasidone
180
which atypical antipsychotics cause the more increase in prolactin levels
riperidone, paliperidone
181
which atypical antipsychotics have negligible effects on glucose
aripiprazole, asenapine, iloperidone, lurasidone, ziprasidone
182
which atypical antipsychotics have increased effects on lipids
clozapine, olanzapine
183
which atypical antipsychotics have negligible effect on QTC
aripiprazole, paliperidone, risperidone
184
baseline monitoring for all atypical antipsychotics
AIMS, CBC, Chem 7, TFTs, Lipids, A1C, EKG, BP, Pulse, Wt, Pregnancy test, BMI
185
Baseline monitoring for quetiapine
atypical antipsychotics + eye exam
186
Basline monitoring for ziprasidone
atypical antipsychotics + hypo mg++ and K+
187
monitoring for all atypical antipsychotics monthly
resolution of symptoms, BP, pulse, Wt, BMI
188
monitoring for all atypical antipsychotics quarterly
lipid panel, fasting glucose, a1C
189
monitoring for all atypical antipsychotics twice a year
AIMS
190
monitoring for quetiapine twice a year
AIMS + eye exam
191
Monitoring for all atypical antipsychotics annually
EKG, Chem 7, TFTs, CBC
192
Monitoring for clozapine at baseline
AIMS, CBC with diff, Chem 7, TFTs, Lipids, A1C, EKG, BP, Pulse, weight, Pregnancy test
193
What antipsychotics are preg cat B
clozapine, lurasidone
194
monitoring for clozapine for first 2 weeks
daily BP + pulse
195
monitoring for clozapine weekly for first 6 months
WBC+ ANC
weight
if > 5% weight gain = FBS, vitals, resolution of symptoms
196
monitoring for clozapine biweekly for months 6-12
WBC+ANC
197
monitoring for clozapine every 4 weeks for months 12+
WBC+ANC
198
monitoring for clozapine monthly
BP, pulse
199
monitoring for clozapine quarterly
lipids, glucose, A1C
200
monitoring for clozapine twice a year
AIMS
201
monitoring for clozapine annually
EKG, CBC, chem 7, TFTs
202
Pregnancy cat for all typical antipsychotics
C
203
name high potentcy typical antipsychotics
thiothixene, haloperidol, fluphenazine
204
name low potentcy typical antipsychotics
chlorpromazine
205
high potentcy antipsychotics have more what
EPS
206
low potency antipsychotics have more what
sedation, hypotension, and anticholinergic effects
207
baseline monitoring for typical antipsychotics
AIMS, CBC, chem 7, TFTs, A1C, EKG, BP, pulse, temp, weight, BMI, pregnancy
208
monitoring for typical antipsychotics monthly
resolution of symptoms, BP, pulse, weight, BMI
209
monitoring for typical antipsychotics quarterly
A1C
210
monitoring for typical antipsychotics twice a year
AIMS
211
monitoring for typical antipsychotics annually
EKG, chem 7, CBC, eye exam if doses > 2000 mg/day
212
monitoring for fluphenazine annually
EKG, chem 7, CBC
213
5 indicators of a good response for schizophrenia
```
acute onset
good premorbid adjustment
late age of onset (late 20s)
short duration of illness
presence of precipitating factors
```
214
3 indicators of a poor response for schizophrenia
primarily negative symptoms
cognitive deficits
dual diagnosis
215
5 indicators for hospitalization
```
risk of harm to others?
risk of suicide
risk of accidental injury
severe disorganization
severe psychotic symptoms (catatonia)
```
216
treatment goals for the first 7 days of hospitalization
decrease agitation
decrease hostility and aggression
normalize eating and sleeping
217
how long to treat first psychotic episode
until remission of symptoms plus 24 months
218
how long to treat those with multiple psychotic episodes
usually life long therapy
| 5 years then consider lower dose
219
aburpt discontinuation of antipsychotics leads to what symptoms
```
salivation
lacrimation
insomnia
vivid dreams
N/V/diarrhea
sweating
rebound cholinergic outflow - SLUD
```
220
factors that favor a more gradual taper of antipsychotics
```
history of violence/aggression
suicide attempts
high doses
severe course of illness
switching to or from clozapine
```
221
conversion from oral fluphenazine to depot injection dose
1.2 x total daily dose to nearest 12.5 mg weekly for 4-6 weeks
222
conversion from oral haloperidol to depot injection dose
10 x total daily dose to nearest 50 mg monthly (max dose 100 mg) if higher than 100 mg given rest 4-7 days later
223
given oral dose how long after starting depot for haloperidol
first month
224
given oral dose how long after starting depot for fluphenazine
first week
225
fluphenazine depot dose
25-50 mg Q 2 weeks
226
haloperidol depot dose
150 mg Q 4 weeks
227
mood stabilizers used to augment antipsychoticss
lithium, valproic acid, carbamazepine, gabapentin, lamotrigine
228
SSRIs used to augment antipsychotics
paroxetine, fluoxetine, sertraline, fluvoxamine, citalopram
229
adequate trial of propranolol to augment antipsychotics
6-8 weeks
230
what is considered an adequate trial of an antipsychotic
6-8 weeks at upper end of dosage range
231
Medications to consider with new diagnosis of schizophrenia
```
single atypical antipsychotic
aripiprazole
olanzapine
quetiapine
risperidone
ziprasidone
```
232
medications to consider if failed first schizophrenia therapy
different atypical or typical antipsychotic
233
medication to consider if failed two schizophrenia therapies
clozapine
234
AEs of typical antipsychotics
sedation, EPS, anticholinergic, orthostasis, weight gain, increased prolactin
235
Which atypical causes the most sedation
clozapine
236
Which atypicals cause moderate sedation
lurasidone
olanzipine
quetiapine
237
Which atypicals cause moderate EPS
paliperidone
risperidone
ziprasidone
238
which atypicals have negligible effects on EPS
aripiprazole
| iloperidone
239
Which atypicals have neglible anticholinergic effects
aripiprazole
asenapine
ziprasidone
240
which atypicals have the most anticholinergic effects
clozapine
241
which atypicals have moderate anticholinergic effects
iloperidone
| olanzipine
242
Which atypicals have the most orthostasis
clozapine
| iloperidone
243
which atypicals have low orthostasis
aripiprazole
| ziprasidone
244
which atypicals have the most weight gain
clozapine
| olanzipine
245
which atypicals have the least weight gain
aripiprazole
lurasidone
ziprasidone
246
which atypical has no effect on prolactin
aripiprazole
247
which atypicals have the most effects on prolactin
paliperidone
| risperidone
248
Which atypicals have neglible effect on glucose
```
aripiprazole
asenapine
iloperidone
lurasidone
ziprasidone
```
249
which atypicals have moderate effect on glucose
clozapine
| olanzipine
250
which atypicals have neglible effects on lipids
```
aripiprazole
asenapine
iloperidone
lurasidone
ziprasidone
```
251
which atypicals have the most effect on lipids
clozapine
| olanzipine
252
which atypical has a moderate effect on lipids
quetiapine
253
which atypicals have negligable effects on QTC
aripirazole
paliperidone
risperidone
254
which typical antipsychotics are phenothiazines
```
chlorpromazine
fluphenazine
thioridazine
perphenazine
trifluoperazine
```
255
which typical antipsychotics are butyrophenones
haloperidole
256
which typical antipsychotics are diphenylbutylpiperadines
pimozide
257
which typical antipsychotics are thioxanthenes
thiothixene
258
which typical antipsychotics are high potency
fluphenazine
haloperidol
thiothixene
259
which typical antipsychotics are low potency
chlorpromazine
260
which typical antipsychotics are medium potency
perphenazine
261
which augmenters are used for mood stabilization (labile mood and aggression)
```
lithium
valproic acid
carbamazepine
gabapentin
lamotrigine
```
262
how long is an adequate trial of an augmenter
2 weeks
| EXCEPTION propranolol 6-8 weeks
263
which SSRIs are used to augment antipsychotics
```
paroxetine
fluoxetine
fluvoxamine
citalopram
sertraline
```
264
When is propranolol used to augment antipsychotics
aggressive especially in demented
265
which antipsychotics should be started after diagnosis of schizophrenia
```
aripiprazole
olanzapine
quetiapine
risperidone
ziprasidone
```
266
After a patient fails one atypical antipsychotic in schizophrenia what should be started
any antipsychotic
267
when should clozapine be started
after failing 2 antipsychotics
268
which typical antipsychotics cause high sedation
chlorpromazine
| thioridazine
269
which typical antipsychotics cause moderately high sedation
lozitane
270
which typical antipsychotics cause moderate sedation
perphenazine
| trifluoperazine
271
which typical antipsychotics cause low sedation
thiothixene
fluphenazine
haloperidol
272
which typical antipsychotics cause high EPS
fluphenazine
haloperidol
perphenazine
thiothixene
273
which typical antipsychotics cause moderately high EPS
chlorpromazine
loxitane
thioridazine
trifluoperazine
274
which typical antipsychotics cause high anticholinergic effects
thioridazine
275
which typical antipsychotics cause moderately high anticholinergic effects
chlorpromazine
276
which typical antipsychotics cause moderate anticholinergic effects
loxitane
| perphenazine
277
which patients have higher incidence of acute dystonic reactions
male
> 40
high potency typical
278
what is given to treat acute dystonic reactions
benztropine 2 mg IV or lorazepam 2 mg IM
279
define acute dystonic reactions
acute muscle rigidity of face, neck, tongue
280
when is an acute dystonic reaction likely to occur
first week of treatment
281
when is akathisia likely to occur
within the first 3 months
282
define akathisia
inability to sit still
283
how to you manage antipsychotic induced akathisia
lower dose, switch to atypical AP, or beta blocker (atenolol 50 mg/day)
284
how to manage AP induced akinesia
decrease dose or d/c
285
define akinesia
lack of spontaneous activity
286
when is pseudo parkinsonism likely to occur
1-2 weeks after start up to 3 months
287
who is more likely to get pseudo parkinsonism
female
| older
288
how to mange AP induced pseudo parkinsonism
atypical or bentropine 1 -4 mg BID
289
What is neuroleptic malignant syndrome
```
fever
altered conciousness
autonomic dysfunction
lead pipe rigidity
lactic acidosis, renal failure, rhabdomylisis
```
290
how to treat NMS
stop AP
ICU
supportive care
291
which is more likely to get NMS
```
high potency antipsychotics
depot antipsychotics
dehydrated
physical exhaustion
organic mental disorders
```
292
When does tardive dyskinesia occur
months to years
293
define tardive dyskinesia
abnormal involuntary movements; irreversible
294
risk factors for tardive dyskinesia
```
older
organic mental disorder
DM
mood disorders
Female
long term use
daily dosage
```
295
how to treat tardive dyskinesia
prevent -> regular AIMS (Q6Mo)
| clonazepam?
296
Which typical antipsychotics lower seizure threshold
phenothizaines
| clozapine + chlorpromazine
297
Typical antipsychotics should be used with caution with what other medications due to increased orthostasis
antihypertensives
298
Oral anticoagulants should be avoided with which typical antipsychotics
phenothiazines
