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Top 100 Drugs (Brand-Generic) > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Which drugs in schizophrenia are used for RAPID acute tranquilization

A

RAPID IM:

1) Haloperidol
2) Aripiprazole
3) ziprasidone
4) zyprexa

HAZZ*

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2
Q

Deconate formulations for typicals/Atypicals

A

Haldol : monthly

Fluphenazine: 2-4 weeks

Risperdal Consta: IM Q 2W

Paliperidone Palmitate: Invega sustenn, Invega Trinza

Aripiprazole: Abilify Maintena

Aripiprazole lauroxil (Aristada) IM Q4-6 wks

Olanzapine(zyprexa Relprevv)

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3
Q

Which agents increase prolactin the most?

A

Galaxtorrhea, amenorrhea, gynecomastia, and impotence

From 2nd Gen:

1) Risperidone
2) Paliperidone

**Aripiprazole has NOT been shown to elevate prolactin levels

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4
Q

Thorazine

A

Chlorpromazine

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5
Q

Mellaril

A

Thioridazine

TYPICAL

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6
Q

Serentil

A

Mesorridazine

TYPICAL AP

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7
Q

Loxitane

A

Loxapene

**Adasuve for ACUTE aggitation assoc w/ schizo

** ORAL INHALATION by HCP

caution: bronchoconstriction

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8
Q

Moban

A

Molindone

TYPICAL AP

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9
Q

Trilafon

A

Perphenazine

TYPICAL

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10
Q

Stelazine

A

Trifluoperazine

TYPICAL

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11
Q

Navane

A

Thiothixene

Typical

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12
Q

Prolixin

A

FluPhenazine

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13
Q

Haldol

A

QT prolongation

Torsades de pointes

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14
Q

Orap

A

Pimozide

Used for TOURETTES ONLY

QT PROLONGATION

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15
Q

Ingrezza

A

Valbenacine

Treats: Tartive dyskinesia

Reduces dopamine release into synaptic cleft

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16
Q

What is treatment for NMS ??!

A

1) D/C AP
2) IV FLUID, COOLING, decrease BP
3) ^ DA with DA agonist (BROMOCRIPTINE)

4) Dantrolene - muscle relaxant treatment of malignant hyperthermia

( Dantrium- PO caps, Revonto- IV, Ryanodex-IV)

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17
Q

Clozaril, FazaCLO, versaCLOZ,

A

ClozaPINE (ATYPICAL)

MOA: blocks D4, 5HT2, alpha, H1

Treats: schizo thats treatment resist.

Forms: oral tabs
FazaCLOZ - ODT
VERSACLOZ - oral yello SUSP

DI: substrate of CYP1A2, caution w/ fluvoxamine and CIPROFLOXACIN

Benefit: DOES NOT CAUSE EPS OR TD or PROLACTIN

SE: agranulocytosis: > 1500 prior to starting
       Myocarditis: BBW W/ Heart Disease
       Thromboembolic eventS: PE
       ORTHOSTASIS** ( BBW)
       Hypersalivation & sweating
       Seizures > 600mg/d
       ^ glycemia/ lipids/ weight gain
       ** SEDAtion**

PART OF REMS PROGRAM

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18
Q

Risperdal

A

Risperidone

Treats: schizophrenia, Bipolar mania, autism

Forms: oral tabs
ODT
oral SOLN
IM depot (CONSTA) - Q2 Wks. Tabs for 3 wks comb

Se: ^EPS, mod weight gain, slight ^ prolactin

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19
Q

Zyprexa/ Zydis

A

Olanzapine

Treats: schizo, bipolar disorder, depress assoc w/ bipolar, Depression thats TREATMENT RESISTANT.

Forms: oral tabs
ODT - Zydis
IM- Zyprexa RelPREV
IM- RAPID

SE: WEIGHT GAIN + DIABETES more common
Hyperglycemia, hyperlipidemi,

Monitor: weight, Glucose, Lipids, DRESS( rash, fever s/s), IM - Orthostasis,

Zyprexa RELPREVV program ( LIKE REMS)

Combo: symbyax(olazapine + fluoxetine)

20
Q

Seroquel/ seroquel XR

A

Quetiapine

Treats: schizo
Bipolar
Major depp disorder(MDD)

Forms: oral tabs only

XR: Empty stomache or light meal

SE: hepatic dsfx & HYPOTENSION

21
Q

GeoDON

A

Ziprasidone

Forms: oral tabs
IM

Treats: schizo & Bipolar disorder

W/ food increases ABSORPTION (20mg BID)
MAX: 80mg/d

**Acute agitaion: 10-20mg IM (RAPID)

Advantages: **low WT GAIN, NO diabetes

SE: QT PROLONGATION(BBW), bradycardia, decrease electrolytes)

   **WARNING: ziprasidone is assoc w/ rare but serious SKIN rxs. If your patient has fever w a RASH and or swollen lymph glands they must seek URGENT MEDICAL ATTENTION
22
Q

Abilify, Aristada-IM

A

Aripiprazole

MOA: partial agonist of D2 and 5-HT1a, and as an antagonist at the 5-HT2a receptor

Forms: (tabs, ODT, oral sln, IM-DEPOT & RAPID)

Maintena- once MONTHLY
Aristada- IM 4-6 WEEKS

Indication: schizophrenia
Bipolar
Depression
Autism

Dose: 10-15mg QD. Max 30mg/d

Substrate of CYP3A4 & 2D6, WATCH FOR DRUG INTERACTIONS

Advantages: LONG T1/2
No weight GAIN,
NO CARDIAC, LOW
RISK OF EPS,

Abilify Maintena: 400mg IM Monthly
Aristada: q4-6 weeks (3wks of ORAL)

  • ## Strong 2D6 or 3A4 inhibitors (300mg)
23
Q

InvegA

A

Paliperidone

Indication: schizophrenia

MOA: Blocks D2, S2, alpha 2

Forms: 1.5mg, 3mg, 6mg, 9mg tabs
Deconate IM FORM

Dose: ER tabs; 3-12QD
Delivers smooth plasma levels over 24 hrs. (OROS)

Dosing: INDIVIDUALIZED specifically to pts RENAL FUNCTION

Max: 3mg for mod-severe RENAL impairment
Max: 6mg for mild RENAL

Caution: Can PROLONG QT interval

24
Q

Invega Sustenna

A

Paliperidone XR IM

Deconate formulation

117mg IM MONTHLY
- DOES NOT need PO overlap

Administered in: DELTA OR GLUTEAL

25
Q

Invega TRINZA

A

Paliperidone DEC

  • 3 MONTH IM

: used only after they have been on MONTHLY IM paliperidone (Invega sustenna) for at least 4 months

: DELTOID OR GLUTEAL

26
Q

Fanapt

A

iLoperidone

Treats: schizo

Forms: tabs ONLY

  • TITRATE SLOWLY TO AVOID ORTHOSTASIS
  • Not recommended in HEPATIC impairment
  • QT prolongation**
  • DI: Reduce dose by 1/2 when w/ CYP2D6 & CYP3A4
27
Q

Which Antiphsychotics have the most ORTHOSTASIS?

A

Clozaril (clozapine)

iLoperidone (Fanapt)

28
Q

Saphris

A

Asenapine

Treats: schizo/ Bipolar

MOA: serotonin, adrenergic, alpha,D, H1

Forms: SUBLINGUAL ONLY!!!

Administration: DONT EAT OR DRINK FOR 10 minutes!!!!

Warnings: SERIOUS ALLERGIC RXNS

29
Q

Latuda

A

Lurasidone

Treats: schizophrenia
DEPRESSIVE episodes assoc w/ Bipolar

Forms: 40/80mg tabs

Dose: w/ FOOD**

Drug INTERACTIONS: It is contraindicated w/ strong **CYP3A4 inhibitors and inducers. **

May cause NEUTROPENIA/LEUKOPENIA

NO QT PROLONGATION

30
Q

REXulti

A

MOA: partial D2 agonist/ antagonist of 5-HT2a

Indications: Major Depressive Disorder
SchiOphrenia: 1-4mg QD

Dosage forms: tabs

DI:

  • Strong CYP2D6 (fluoxetine/paroxetine) & CYP3A4 inhibitors DECREASE THE DOSE
  • STRONG inducers : double the DOSE
31
Q

Vyraylar

A

Cariprazine

PARTIAL AGONIST OF D2

treats: Bipolar & SchizophreniA

Form: CAPSULES

Dose: DAILY ONLY !! LONG HALF LIFE

SE: RESTLESSNESS and INSOMNIA

DI: Vraylar is CYP3A4 substrate

BBW: Dont give in DEMENTIA related psychosis

32
Q

Which AP has the best efficacy for schizophrenia?

A

Clozapine

- save for RESISTANT because of SEVERE AGRANULOCYTOSIS

33
Q

Which AP has the most weight gain, DM, dyslipidemia, and antichinergic!!

A

Clozapine

Olanzapine

34
Q

Which AP have lowest to NO weight GAIN?

A

Ziprasidone

Lurasidone

Aripiprazole

Note: iLoperidone has a moderate wt gain and low DIABETES & dyslipidemia

35
Q

Which AP do I recommend if I’m worried about QT prolongation?

A

ABILIFY (aripiprazole)

LaTUDA (lurasidone)

RexuLTi (brexpiprazole)

Vraylar (caripazine)

36
Q

Which AP can I recommend for RESISTANT DEPRESSION?

A

1) Abilify
2) Seroquel XR
3) Symbyax
4) Brexpiprazole (Rexulti)

37
Q

Which AP can I recommend for Bipolar?

A

1) Risperidone
2) Geodon (zuprasidone)
3) Abilify
4) Seroquel
5) Saphris
6) Latuda
7) Zyprexa
8) vraylar

38
Q

Which AP are ODT?

A

Clozapine

Olanzapine

Abilify

risperidone

(ROCA)

39
Q

Which AP MUST be taken w/ FOOD?

A

LATUDA (Lurasidone)

GEODON (Ziprasidone)

40
Q

Which AP must be taken on an EMPTY STOMACHE?

A

Quetiapine XR

41
Q

Treatment for akathesia?

A

Propanolol

Lorazepam

42
Q

Parkinsonism

A

Benztropine

Amantadinr

43
Q

Treatment of dystonia?

A

Benztropine

Diphenhydramine

44
Q

How to treat NMS?

A

Bromocriptine - D2 agonist

Dantrolene - muscle relaxant

Cooling blankets - lower TEMP

45
Q

Which AP is available as a sublingual tablet?

A

Asenapine

46
Q

Which AP are available as an ORAL SOLUTION?

A

Aripiprazole

Clozapine

Risperidone

47
Q

Which AP is available as an oral INHALATION?

A

Loxapine (ADASUVE)

Top 100 Drugs (Brand-Generic) (19 decks)

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