Schizophrenia Brand/Generics Flashcards
*Thorazine
Chlorpromazine
Thioridazine
Mellaril
Mesoridazine
Serentil
*Loxitane
- Indication
- Administration
*Loxapine
- Indication: acute agitation ass w/ scz or bipolar I disorder
- Adm by a healthcare professional 10mg PO inhalation using a inhaler
Molindone
Moban
Perpenazine
Trilafon
Trifluoperazine
Stelazine
Thiothixene
Navane
*Prolixin
Fluphenazine
- Haldol
- Major SEs
Haloperidol
- QT Prolongation, Tordades de pointes
- ORAP
- Indication
PIMozide
- Indication: used for Tourette’s only
SEs of these drugs
Anticholinergic SEs
Extrapyramidal SEs
- Causes:
- S/S
- Agents have higher risk
- Agents have lowest risk
Tardive dyskinesia
- Cause
Neuroleptic malignant syndrome
- S/S
- Cause
- Management
SEs: WASH MEN
- Weight gain: block histamine H1 receptor
- Anticholinergic: block cholinergic receptor
- Sedation: Block histamine
- Hypotension: block alpha-adrenergic
- Movement disorder - Tardive dyskinesia
- EPSE
- Neuroleptic Malignant Syndrome (NMS)
Anticholindergic SEs => Anti- SLUDGE
- Salivation
- Lacrimation
- Urination
- Defecation
- GI motility
- Excretion
Extrapyramidal SEs
- Causes: due to dopamine antagonist activity
- S/S
Dystonia: hrs - day: painful muscle spasm laryngospasm
IV diphenhydramine 25-50mg
Akathisia: days to weeks. Restlessness
Propanolol 30-100 mg QD
Pseudoparkinsonism: weeks to mo
Decrease Ach or Inc dopamine. Benztropine,
Trihexyphenidyl, diphenhydramine, amantadine
Tardive Dyskinesia
- Cause: hypersensitivity rxn due to prolonged blockade of dopamine. Tongue, lip, jaw, face, and extremity movement
Neuroleptic Malignant syndrome
- S/S: rigidity, fever, diaphoresis, altered consciousness, incr BP, increased HR
- Cause: due to depletion of DA in CNS = disruption of muscle contraction, disruption of thermostat system
- Management
D/C drug
Supportive therapy: IV fluid, cooling
Increase DA by DA agonist (bromocriptine)
Dantrolene: muscle relaxant tx of malignant hyperthermia
Agents for rapid transquilization given IM
HAZO
- Haloperidol: 5-10mg IM Q1H prn
- Aripiprazole 7.5mg/mL repeat in 2H max 30mg/d
- Ziprasidone 10-20mg IM. Max 40
- Olanzapine 2.5-10mg IM. May repeat in 2H. Max 30mg/d
Deconate agents
- Halol
- Fluphenazine
- Resperdal
- Paliperidone
- Ability maintain
- Zyprexa Relprevv
- Halol 10-15x PO given monthly
- Fluphenazine Q2W
- Risperdal Consta: > 18 y.o given by 25mg (max 50) deep IM Q2W
Give PO x 3wks then stop PO - Paliperidone Palmitate
Give 234mg on day 1, then 156mg on week later.
MD given 117 IM injection once a month - Ability maintena IM depot QM
- Zyprexa relprevv (olanzepine ER)
150mg to 300mg Q2W or
405 mg Q4W
Clozaril
- MOA
- Indication
- Dose
- Benefits
- SEs
Clozapine:
=» Must register in Clonazril National Register (CNR)
- MOA: block D4, 5HT2, alpha, histamine
- Indication: Szc (treatment resistant)
- Dose: 300-900mg/day
- Benefits: doesn’t cause EPS or TD or prolactin level
- SEs:
Agranulocytosis: WBC > 3.5K, ANC > 2k
Hypersalivation and sweating
SZ
Hyperglycemia/lipidemia
Wt gain
Sedation
Resperdal
Resperdal consta
- Indication
- Forms
- Disadvantage
Risperidone
- Consta: IM inj Q2W => Give 1st dose of oral dosage form. Continue for 3wks then d/c oral
- Indication: scz, bipolar mania, autism
- Forms: Tab, disintergrating tabs, sol’n, IM inj (consta)
- SEs: higher risk of EPS
Zyprexa
Zyprexa Relprevv
Zydis = ODT
- Zyprexa Relprevv dose Warning, registration - Indication - SEs - Monitor - Zydis counseling ODT
Olanzapine
- Atypical
Zyprexa Relprevv:
- ER => give 150-300mg PO Q2W or 405mg Q4W
- Can cause post injection delirium/sedation
- Must register in ZYPREXA RELPREVV pt care program
- Indication: Scz, bipolar, depression, depression resistant use with fluoxetine
- SEs: Wt gain and DM, hyperG/lipidemia
- Monitor: wt, glucose, lipids, orthostatic hypoTN (IM)
Zydis counseling ODT
- Must keep tablet in blister pack until ready to take
- Open the package n peel back the foil from the tablet blister
- Do not push a tablet through the foil; you may damage the tablet
- Using dry hands, remove the tablet - place it in your mouth. It will begin to dissolve right away
- Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing
- Swallow several times. If desire, pt may drink liquid to help swallow the dissolve tablet
Seroquel
- Indication
- Dose
- Benefit
Quetiapine
- Indication: Scz, bipolar, major depression
- Dose: 100-800mg/d HS empty stomach
- Benefit: lowest anticholinergic of all atypical
Geodon
- Indication
- Dose
- Benefits
- Disadvantage
Ziprasidone
- Indications: Scz, bipolar
- Dose: start 20mg PO BID with Food. Max 80mg BID
- Benefit: least weight gain and DM
- SEs: Prolong QT
Abilify
Ability Maintena
- Indication
- Dose
- Adv
Aripiprazole
- Abilify DISMELT: contain phenylalamine
- Ability Maintena: QM injection
- Indication: Scz, bipolar, depression, autism
- Dose 10-15mg QD. Max 30mg
Maintena: 400mg IM QM - Adv:
Long elimination half life
Low risk of wt gain
No cardiac effects
Relatively low risk EPS
InVEGA
- Indication
- Dose
- Paliperidone palmitate
- SEs
PaLIPerdone
- Indication: scz
- Dose: 3-12 mg PO QD
=> Drug delivers over 24H using innovative OROS - Paliperidone Palmitate Inj: 117 mg QM
=> Start 234mg on D1 then 156 mg 1W later - SEs: QT prolong
Fanapt
- Indication
- Dose
- SE
ILoperidone
- Indication: scz
- Dose: start 1mg BID. Target 6-12mg BID due to
- Orthostatic hypoTN
Saphris
- Form
- Indication
- MOA
- Dose
Direction to take - SEs
Asenapine
- Sublingual only. Swallow = not working
- Indication: scz, bipolar
- MOA: serotonin, adrengergic alpha, dopamine, and histamine
- Dose:
Scz: 5mg SL BID. Do not drink or eat for 10min after arm
Bipolar: 5-10mg BID - SEs: serious allergic rxn
Do not use in pt w/ dementia-related psychosis = death
Latuda
Lurasidone
- Indication: scz
- Dose: 40-80mg QD with FOOD
- SEs: neutropenia, leukopenia
- Highest wt gain
- No wt gain, DM, dyslipidemia
- No QT
- Agents for depression
- Agents from bipolar
- Agents for autism
Wt gain
- Clozapin n olanzepine
No wt gain
- Ziprassidone, aripiprazole, paliperidone, asenapine
No QT = AI LO
- Saphris, abilify, latuda, zyprexa
Depression
- Abilify, seroquel, zyprexa
Bipolar
- Resperidone, geodon, ability, seroquel, saphris, zyprexa
Autism
- abilify and resperdone
Dantrium
- Indication
Dantrolene
- Muscle relaxant tx of malignant hyperthermia
Adusuve
- Class
Loxapine
- Typical
FazaClo
Clozapine
- Form: ODT
- I: SZP resistant
Versacloz
- Form
- Expiration
- Indication
Clozapine
- Form: Yellow suspension. Protect from light. Shake 10s b/4 use.
- Exp 100 days after bottle is opened
- I: SZP resistant
