Schizophrenia/Psychosis Flashcards
List Extrapyramidal side effects
dystonias akathisia parkinsonism tardive dyskinesias dyskinesias
Define dystonias
prolonged contraction of muscles during initiation, including painful muscle spasms; life-threatening if airway is compromised. higher risk with younger males. Centrally-active anticholinergics (diphenhydramine, benztropine) can be used for prophylaxis or treatment
Define akathisia
restlessness with anxiety and an inability to remain still; treated with anticholinergics (diphenhydramine, benztropine), BZD, or propranolol
Define Parkinsonism
looks similar to parkinson disease with tremors, abnormal gait and bradykinesia; treated with anticholinergics, or propranolol if tremor is the main symptom
Define tardive dyskinesias
abnormal facial movements, primarily in the tongue or mouth; higher risk with elderly females. TD can be irreversible. must stop the drug and replace with an SGA with low EPS risk (quetiapine, clozapine)
Define dyskinesias
abnormal movements; more common with dopamine replacement for parkinson disease
dopamines role in schizophrenia
they have increased level of dopamine
DSM-5 for schizophrenia
delusion, hallucinations, or disorganzied speech must be present negative S/Sx -loss of interest -lack of emotion (apathy) -social withdrawal -loss of motivation -lack of speech postive S/Sx -hallucinations -delusions -disorganized thinking/behavior
First-generation antipsycotics MOA
mainly by blocking dopamine and minimal serotonin receptor blockade
FGA major SE
EPS
name a high potency FGA
haloperidol
Boxed warning for all FGA & SGA
elderly patients with dementia-related psychosis have an increased risk of death
Second-generation anti-psychotics MOA
blocking dopamine and serotonin receptors
which SGA has the highest risk of QT prolongation
ziprasidone
drug with lowest risk of EPS
quetiapine
