TOPIC 7 - psychotic disorder meds

Question 1

antipsychotic meds

Answer 1

alleviate symptoms of schizophrenia but cannot cure the underlying process

Question 2

even with med compliance…

Answer 2

relapse can occur

Question 3

antipsychotic meds are effective for

Answer 3

acute exacerbations of schizophrenia
reducing number of relapse
lessening effects of relapse

Question 4

1st gen vs 2nd and 3rd

Answer 4

1st gen - target positive symptoms
2nd/3rd - target positive and negative

Question 5

1st gen antipsychotics

Answer 5

chlorpromazine
fluphenazine
heloperidol
perphenazine

meds are inexpensive and available in PO or IM

Question 6

antipsychotic side effects

Answer 6

drowsy, dizzy, seizures, anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention, tachycardia), EPS, TD, NMS, agranulocytosis, body temp alterations, photosensitivity

Question 7

neuroleptic malignant syndrome symptoms

Answer 7

Sudden high fever
Sweating
Rigidity
Dysrhythmias
Fluctuations in BP
Decreased LOC
Respiratory failure

Question 8

treat NMS symptoms with …

Answer 8

bromocriptine or dantrolene

Question 9

extrapyramidal symptoms

Answer 9

acute dystonia, pseudoparkonism, akathisia, tardive dyskinesia

Question 10

features of movement disorders in EPS

Answer 10

Rigidity (lead pipe, cogwheeling)
Bradykinesia
Mask-like face
Shuffling gait
Tremor
Postural deficits
Chorea
Hemiballismus
Athetosis
Dystonia
Tics

Question 11

tardive dyskinesia

Answer 11

abnormal involuntary movements of face, mouth, trunk, limbs

Question 12

EPS treatment

Answer 12

benztropine
diphenhydramine

Question 13

early symptoms of TD

Answer 13

tongue fasciculations
constant lip smacking

later = oral movement, facial tics

Question 14

AIMS assessment

Answer 14

measures involuntary movements seen in TD

Question 15

drugs to lessen severity of movements in TD

Answer 15

VMAT2 inhibitor

Question 16

atypical antipsychotics

Answer 16

clozapine (Clozaril)
olanzapine (Zyprexa)
paliperidone (Invega)
quetiapine (Seroquel)
risperidone (Risperdal)
ziprasidone (Geodon)
asenophine (Saphris)
aripiprazole (Abilify)
brexpiprazole (Rexulti)

Question 17

antipsychotic med side effects

Answer 17

constipation, lowered seizure threshold, metabolic effects, weight gain, hyperglycemia, metabolic syndrome, agranulocytosis, cardiomyopathy, prolonged QT interval, liver impairment

gynecomastia and hyperprolacinemia (with risperidone)

Question 18

1st gen vs 2nd gen side effects

Answer 18

1st - EPS, TD, body temp alteration, neuroleptic malignant syndrome

2nd-EPS, TD, metabolic syndrome, constipation, QT prolongation, agranulocytosis, gynecomastia, cardiac dysrhythmia