Schizophrenia: Meds & Side Effects

Question 1

Chlorpromazine (Thorazine)

Answer 1

Conventional; most sedating, low EPS, high htn

Question 2

Thioridazine (Mellaril)

Answer 2

Conventional

Question 3

Loxapine (Loxitane)

Answer 3

Conventional

Question 4

Paliperidone (Invega)

Answer 4

Atypical

Question 6

Molindone (Moban)

Answer 6

Conventional

Question 7

Perphenazine (Trilafon)

Answer 7

Conventional

Question 8

Trifluoperazine

Answer 8

Conventional

Question 10

Risperidone (Risperdal)

Answer 10

Atypical

Question 11

Thiothixene (Navane)

Answer 11

Conventional

Question 12

Fluphenazine (Prolixin)

Answer 12

Conventional

Question 14

Haloperidol (Haldol)

Answer 14

Conventional; Least sedating, high EPS, low htn

Question 15

Pimozide (Orap)

Answer 15

Conventional

Question 17

Conventional Antipsychotics

Answer 17

First generation; dopamine antagonists or dopamine receptor antagonists; only treat positive sx

Question 18

Atypical Antipsychotics

Answer 18

Second generation; Serotonin-dopamine antagonists; treat both positive and negative sx

Question 19

Negative Sx of Clozapine (Clozaril)

Answer 19

Agranulocytosis in 0.8-1% (must have weekly WBC for the first 6 months); increased risk for seizures

Question 20

Advantage of Atypical Antipsychotic

Answer 20

Treats both positive and negative sx; little to no EPS or tardive dyskinesia

Question 21

Disadvantage of Atypical Antipsychotic

Answer 21

May cause significant weight gain or metabolic syndrome (with exception of Ziprasidone & Aripiprazole; more expensive than conventional

Question 22

Length of time for antipsychotic meds to take effect

Answer 22

2-6 weeks

Question 23

Disadvantages of Conventional Antipsychotics

Answer 23

May cause EPS, anticholinergic effects (dry mouth, constipation, urinary retention, htn), orthostasis, photosensitivity, lowered seizure threshold

Question 24

Advantages of Conventional Antipsychotics

Answer 24

Lower cost than Atypical; some available in long-acting form

Question 25

Olanzapine (Zyprexa)

Answer 25

Atypical

Question 26

Anticholinergic Toxicity

Answer 26

Medication induced, potentially life threatening side effects: hyperthermia, hot/dry/red skin, paralytic ileus, agitation, delirium, fluctuating vital signs, tachycardia, marked mydriasis, confusion, mental status changes, worsening psychotic sx, coma

Question 27

Anticholinergic Sx

Answer 27

Urinary retention, dilated pupils, constipation, blurred vision, dry mucous membranes, reduced peristalsis, cognitive impairment

Question 28

Meds to reduce EPS

Answer 28

Antiparkinsonians, anticholinergics (i.e. Cogentin or Benadryl), or benzodiazapines (i.e. Lorazepam)

Question 29

Neuroleptic Malignant Syndrome (NMS)

Answer 29

Acute, life-threatening medical emergency characterized by severe EPS, hyperpyrexia (above 103 degrees F), autonomic dysfunction (htn, tachycardia, diaphoresis, incontinence), delirium, stupor, coma.

Question 30

Tx of Neuroleptic Malignant Syndrome (NMS)

Answer 30

DC antipsychotic, management of fluid balance, temperature reduction, monitor for complications

Question 33

Metabolic Syndrome

Answer 33

Disadvantage of atypical antipsychotics; causes weight gain, dyslipidemia, altered glucose metabolism; increases risk for diabetes, htn, atherosclerotic heart disease

Question 34

Quetiapine (Seroquel)

Answer 34

Atypical

Question 38

Aripiprazole (Abilify)

Answer 38

Atypical

Question 40

Ziprasidone (Geodon)

Answer 40

Atypical

Question 42

Clozapine (Clozaril)

Answer 42

Atypical