Schizophrenia Case

Question 1

8 clinical uses of antipsychotic agents

Answer 1

shizophrenia
bipolar
psychotic depression
senile psychosis
drug-induced psychosis
mood enhancement
anti anxiety
sleep disorders

Question 2

3 first gen antipsychotics (FGA)

Answer 2

phenothiazines - chlorpromazine (thorazine)
thioxanthenes - thothixene (navane)
butyrophenones - heloperidol/droperidol (haldol)

Question 3

3 s.e of phenothiazines

Answer 3

sedation
weight gain
TD

Question 4

s.e of thioxanthenes

Answer 4

high potency ->
medium EPS
medium sedative
hypotension

Question 5

s.e of butyrophenones

Answer 5

high potency ->
high EPS

Question 6

which FGA is widely used and best for acute, short-term symptom control

Answer 6

butyrophenones (haldol)

Question 7

first line option for schizophrenia

Answer 7

second gen (atypical) antipsychotics (SGA)

Question 8

6 EPS

Answer 8

dystonia
akathisia
parkinsonism
TD
bradykinesia
tremors

Question 9

continuous spasm and muscle contractions

Answer 9

dystonia

Question 10

motor restlessness

Answer 10

akathisia

Question 11

irregular, jerky movements

Answer 11

parkinsonism

Question 12

involuntary muscle movements in the lower face and distal extremities

Answer 12

TD

Question 13

slow movements

Answer 13

bradykinesia

Question 14

why are SGA’s first line (3)

Answer 14

lower risk for:
EPS
TD
cognitive impairment

Question 15

7 SGA/atypical antipsychotics

Answer 15

quetiapine (seroquel)
risperidone (resperdal)
ziprasidone (geodon)
paliperidone (invega)
aripriprazole
clozapin
olanzopine (zyprexa)

Question 16

2 common s.e of SGA’s

Answer 16

weight gain
EPS

Question 17

which 2 SGAs are associated with less weight gain

Answer 17

apriprazole (abilify)
ziprasidone (geodon)

Question 18

which SGA is associated w. less EPS

Answer 18

risperidone (resperdal)

Question 19

which SGA causes the most weight gain

Answer 19

seroquel

Question 20

which SGA causes QT prolongation

Answer 20

ziprasidone (geodon)

Question 21

__ is an active metabolite of risperidone

Answer 21

palperidone (invega)

Question 22

which SGA is associated w. severe risk of neutropenia

Answer 22

clozopin

Question 23

which 2 SGAs are not recommended as first line tx

Answer 23

clozopin - reserved for refractory
olanzapine (zyprexa)

Question 24

you should start dosing for antipsychotics in __ for several weeks

after effective dose has been found, dosing should be __

Answer 24

divided daily doses
once daily

Question 25

antipsychotics are typically given during what time of the day

Answer 25

night

Question 26

3 pharm options for acute psychosis

Answer 26

zyprexa
haldol
benzos

Question 27

route of admin for zyprexa

Answer 27

IM
ODT

Question 28

route of admin for haldol

Answer 28

IV

Question 29

trials of SGA should last for at least __ at a therapeutic dose

Answer 29

6-8 weeks

Question 30

6 more serious s.e of SGA

Answer 30

hyperglycemia, DM, ketoacidosis
HLD
coma
death

Question 31

2 consideration when managing/distinguishing between drug induced psychosis and schizophrenia

Answer 31

give acute antipsychotic for pt evaluation

pt must be fully sober to gauge effectiveness of medication