Week 11 Atypical Antipsychotics and Various Medications Flashcards
Aripiprazole
Abilify
Oral IR; Oral solution; IM; Discmelt
Central Nervous System
Antipsychotic
Atypical Antipsychotic (second generation)
Schizophrenia; Bipolar Disorder; Agitation/psychosis; Adjunctive depression treatment; SHOULD NOT BE USED IN DEMENTIA-RELATED PSYCHOSIS
Weight gain; Glucose/Lipid abnormalities; Tardive dyskinesia; EPS; Akathisia; Somnolence/Sedation
CNS depressants; Azole antifungals
Boxed Warning: Increased risk of death in dementia-related psychosis; Precaution: EPS, alerted cardiac conduction, anticholinergic burden
PATIENT COUNSELINGS
- Stress the importance of taking the medication daily despite how the patients feels
- review drug specific side effects so that the patient is aware they will occur especially WEIGHT GAIN
- discuss monitor of EPS symptoms with patients
Meclizine
Motion sickness
Antivert
Bonine
available OTC 12.5mg only
Oral
Central Nervous System
Antiemetic
Antiemetic; Antihistamine that decreases vestibular conduction
N/V; Motion sickness; Vertigo
Sedation/somnolence; drowsines; dry mouth
CNS depressants; Antihistaminic medications; Anticholinergic medications
Caution use in patients sensitive to anticholinergic side effects
PATIENT COUNSELINGS
- most effective in prophylatic dosing
- dose before exposure to the cause of nausea and vomitting
- sedation may be associated with the use of anti-emetics
Metoclopramide
Reglan
Oral
Gastrointestinal
Motility agent
Enhances acetylcholine activity in GI tract; Blocks serotonin; Dopamine antagonist
Diabetic gastroparesis; GERD; Prevention of N/V (ADULTS ONLY), 12 weeks duration
EPS; Somnolence/Lassitude; Bradycardia; Reslessness
Anticholinergic; Antipsychotics; Parkinson’s Medications; SSRIs; Promethazine
CI: Gi obstruction/perforation, Hx of seizure, Meds with EPS risk; BBW: Tardive dyskinesia
use limited to adults
use limited to 12 weeks durations
PATIENT COUNSELINGS
- take 30mins prior to meals for gastroparesis
- notify a health care provider if you experience any spastic or involuntary movement or altered mentals status
- caution when first starting this medication until you know how drowsiness will affect you
- use should be limited to 12 weeks due to risk of Parkinson’s like symptoms
Olanzapine
Zyprexa
Oral IR; Zydis; Oral solution/suspension
Central Nervous System
Antipsychotic
Atypical Antipsychotic (second generation)
Schizophrenia; Bipolar Disorder; Agitation/psychosis; Adjunctive depression treatment; SHOULD NOT BE USED IN DEMENTIA-RELATED PSYCHOSIS
Weight gain; Glucose/Lipid abnormalities; Tardive dyskinesia; EPS; Akathisia; Somnolence/Sedation
CNS depressants; Azole antifungals; Carbamazepine
Boxed Warning: Increased risk of death in dementia-related psychosis; Precaution: EPS, alerted cardiac conduction, anticholinergic burden
PATIENT COUNSELINGS
- Stress the importance of taking the medication daily despite how the patients feels
- review drug specific side effects so that the patient is aware they will occur especially WEIGHT GAIN
- discuss monitor of EPS symptoms with patients
Ondansetron
chemo or radiation induced nausea and vomiitng
Zofran
Oral (ODT, liquid, film); injection
Gastrointestinal
Antiemetic
Antiemetic; 5HT3 antagonist; CTZ
N/v inducaed by chemotherapy/radiation/surgery
Sedation/somnolence; drowsines; dry mouth, elevated LFTs
CNS medications; Serotonergic medications
QTC prolongation; Serotonin Syndrome; Liver impairment
PATIENT COUNSELINGS
- most effective in prophylatic dosing
- dose before exposure to the cause of nausea and vomitting
- sedation may be associated with the use of anti-emetics
Promethazine
general nausea/vomitting
Phenergan
oral (tablet, liquid); injection; rectal suppository
Central Nervous System
Cough suppressant
Antiemetic; first generation antihistamine;
N/V; Vertigo
Sedation/somnolence; drowsines; dry mouth; photosensitivity
CNS depressants; Antihistaminic medications; Anticholinergic medications
Boxed Warning: Should not be used in children < 2 d/t respiratory depression; May cause parkinsonism symptoms; May cause temperature dysregulatiopn; Can alter cardiac conduction
Promethazine/Codeine
Phenergan AC
** Schedule 5**
oral liquid
Central Nervous System
Cough suppressant combination
Antiemetic; opioid; first generation antihistamine
See individual agents
Quetiapine
Seroquel
Oral (IR, ER)
Central Nervous System
Antipsychotic
Atypical Antipsychotic (second generation)
Schizophrenia; Bipolar Disorder; Agitation/psychosis; Adjunctive depression treatment; SHOULD NOT BE USED IN DEMENTIA-RELATED PSYCHOSIS
Weight gain; Glucose/Lipid abnormalities; Tardive dyskinesia; EPS; Akathisia; Somnolence/Sedation
CNS depressants; Azole antifungals
Boxed Warning: Increased risk of death in dementia-related psychosis; Precaution: EPS, alerted cardiac conduction, anticholinergic burden
PATIENT COUNSELINGS
- Stress the importance of taking the medication daily despite how the patients feels
- review drug specific side effects so that the patient is aware they will occur especially WEIGHT GAIN
- discuss monitor of EPS symptoms with patients
Risperidone
Risperdal
Risperdal Consta
IM; Oral IR; M-TAB; Oral solution/suspension
Central Nervous System
Antipsychotic
Atypical Antipsychotic (second generation)
Schizophrenia; Bipolar Disorder; Agitation/psychosis; Adjunctive depression treatment; SHOULD NOT BE USED IN DEMENTIA-RELATED PSYCHOSIS
Weight gain; Glucose/Lipid abnormalities; Tardive dyskinesia; EPS; Akathisia; Somnolence/Sedation
CNS depressants; Carbamazepine
Boxed Warning: Increased risk of death in dementia-related psychosis; Precaution: EPS, alerted cardiac conduction, anticholinergic burden
PATIENT COUNSELINGS
- Stress the importance of taking the medication daily despite how the patients feels
- review drug specific side effects so that the patient is aware they will occur especially WEIGHT GAIN
- discuss monitor of EPS symptoms with patients
Which of the following medications is an atypical antipsychotic? A. Haloperidol B. Metoclopramide C. Promethazine D. Aripiprazole
D. Aripiprazole
Risperidone (second generation) has a lower risk
of metabolic side effects than haloperidol (first
generation).
A. True
B. False
B. False
Antipsychotics’ side effects are primarily associated with antagonism of which neurotransmitter receptor? A. Dopamine B. Serotonin C. Norepinephrine D. Acetylcholine
A. Dopamine
Which of the following medications is an atypical antipsychotic that is available as a longacting injectable medication? A. Chlorpromazine B. Aripiprazole C. Promethazine D. Quetiapine
B. Aripiprazole
Which atypical antipsychotic has the greatest incidence of weight gain? A. Olanzapine B. Aripiprazole C. Haloperidol D. Risperidone
A. Olanzapine
Atypical antipsychotics are indicated for use
in dementia-related psychosis
A. True
B. False
B. False
