schizoprenia Flashcards
what are the 3 main positive symptoms?
delusions
hallucinations
disorganized speech and behavior
what are the 5 negative symptoms?
grooming
alogia (poverty of speech)
anhedonia (decreased interest)
affect-flat
cognitive
how long do symptoms need to be occurring for diagnosis?
1 month
what are the symptoms that are required for a diagnosis?
delusions, hallucination, disorganized speech. disorganized or catatonic behavior, or negative symptoms
how many symptoms are needed for diagnosis, and which ones are required?
2 or more and at least one must be delusion, hallucination, or disorganized speech
how long after remission should you treat?
12 months
how long until stabilization on treatment?
6-12 months
how long until changes are seen?
2 weeks
what is TRS?
failed trials of at least 2 antipsychotics at max dose
which antipsychotic can take 6 months to work?
clozapine
which generation has EPS?
1st
MOA and class of clozapine
2nd gen
mixed D2/5HT2a antagonist
Which two 1st gens have high H1,a1, and M1 antagonism but low D2 antagonism?
chlorpromazine
thioridazine
(C-Thior)
Which two 1st gens have moderate H1,a1, and M1 antagonism and moderate D2 antagonism?
loxapine
perphenazine
(Loxa-P)
Which 4 1st gens have low H1,a1, and M1 antagonism but high D2 antagonism?
trifluoperazine
thiothixene
fluphenazine
haloperidol
(Tri-Thio-Flu-Hal)
-zine is common to?
1st gens
what is the exception to -zine in first gens
loxapine
haloperidol
thiothixene
which generation has metabolic effects?
2nd
which three 2nd gens high H1,a1, and M1 antagonism but low D2 antagonism?
quetiapine
clozapine
olanzapine
(CoQ)
Which three 2nd gens have moderate H1,a1, and M1 antagonism and moderate D2 antagonism?
iloperidone
paliperidone
risperidone
(RIP)
Which three 2nd gens have low H1,a1, and M1 antagonism and high D2 antagonism?
brexpiprazole
cariprazine
aripiprazole
(CAB)
Which three 2nd gens have lowest H1,a1, and M1 antagonism and highest D2 antagonism?
asenapine
lurasidone
ziprasidone
(ALZ)
what is -pine, -done, and -zole common to?
2nd gen
what is the exception to -pine, -done, and -zole?
cariprazine
which antipsychotics are 1A2 metabolized?
clozapine
olanzapine
astenapine
(CoA)
which antipsychotics are 2D6 metabolized?
risperidone
fluphenazine
clorpromazine
(FCR)
which antipsychotics are 3A4 metabolized?
quetiapine
ziprasidone
lurasidone
(LQZ)
which antipsychotics are BOTH 2D6 and 3A4 metabolized?
iloperidone
aripiprazole
brexpiprazole
cariprazine
haloperidol
(HABIC)
which is renally eliminated?
(RP)paliperidone and risperidone
which have a DDI with smoking?
clozapine and olanzapine
which have DDI with rifampin, ritaonavir, and phenytoin?
quetiapine and ziprasidone
which has the most DDI?
carbamazepine
which 2nd gens have orthostasis, anticholinergic, metabolic rate syndrome, and Low EPS?
(CoQ)
clozapine, olanzapine, quetiapine
which is used for agitation, delirium, anxiety, and depression?
quetiapine
which one is used for TRS, suicidality and in those with PD, alzheimers?
clozapine
which one has black box warning of agranulocytosis, seizure, myocarditis?
clozapine
(T/F) all antipsychotics have a risk of mortality in elderly with dementia related psychosis
T
(T/F) all antipsychotics have a risk of suicidal thoughts?
T, but more common in 2nd gen
which antipsychotics have orthostasis and hyperprolactinema?
(RIP)
risperidone
iloperidone
palperidone
which antipsychotics have partial D2 agonism, long t1/2, akathisia, and lowest metabolic side effects?
(CAB)
aripiprazole, brexpiprazole, cariprazine
which antidepressant is used in tourettes and autism?
aripiprazole
which 2 can be adjunct in MDD?
aripiprazole and brexipiprazole
which is D2 antagonizing?
cariprazine
which antipsychotics are weight neutral and have more EPS risk?
asenapine, lurasidone, zirasidone (ALZ)
with antipsychotic has ulcers, bad taste as a side effect?
asenapine
which antipsychotic needs to be BID with over 500 calories?
ziprasidone
which antipsychotic has highest QTc risk?
ziprasidone
which antipsychotic needs to be with over 350 calories?
lurasidone
which antipsychotic has post injection delirium sedation symptom?
olanzapine LAI
what is pimavanserin’s indication and MOA?
parkinsons psychosis
5HT2a reverse agonist
what is pimozide indication and MOA?
tourettes
D2 antagonist
the mesolimbic is responsible for?
+ symptoms
the mesocortical is responsible for?
neg. symptoms
D2 antagonism is responsible for?
EPS and prolactin stimulation
Akathisia is..,
internal restlessness
akathisia symptoms include…
leg shuffling and cant sit still, pacing
akathisia treatment is…
propanolol
benzos
dystonia is…
involuntary contractions
dystonia symptoms are…
eyes rolling, tongue leaden, cant swallow, neck twisting
dystonia treatment is…
benadryl, benztropine, trihexyphenidyl
parkinsonism is…
brady/hypokinesia, tremor, rigid
parkinsonism symptoms are…
masked face, decreased arm swing, shuffling walk, difficulty moving
parkinsonism treatment is…
benadryl, benztropine, trihexyphenidyl
what is tardive dyskinesia?
abnormal, involuntary movement
what are tardive dyskinesia symptoms?
blinking, lip smacking, jaw movement, grimacing, rocking/twisting, irregular limb movement
what is tardive dyskinesia treatment?
VMAT2 inhibitor
MOA of valbenazine
VMAT2 inhibitor, less Dopa release to synapse
what does Dopa block in the tuberoinfundibular tract cause?
hyperprolactinemia
which antipsychotic causes hyperprolactinemia?
risperidone
which antipsychotics have CV risk?
haloperidol
ziprasidone
thioridazine
(ZHT)
what is the treatment for NMS?
stop all dopa blockers
which antipsychotic is used in pregnancy?
haloperidol
which antipsychotic is used in breastfeeding?
(AQ)aripiprazole and quetiapine
which antipsychotics are AVOIDED in elderly?
(HZ)ziprasidone and haloperidol
