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KC2017 Behavioral Health > Wolters Summary - Antipsychotics > Flashcards

Wolters Summary - Antipsychotics Flashcards

1
Q

BBW antipsychotics

A

elderly patients w/dementia psychosis have increased risk of death

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2
Q

FGA summary

A

more likely to have EPS, TD

ONLY positive

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3
Q

SGA summary

A

less likely to have EPS, TD

negative AND positive

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4
Q

antipsychotics S.E.

A 
sedation 
anticholinergics 
orthostatic hypOtension 
E.P.S.
T.D.
QT prolongation 
Seizure 
Agranulocytosis 
Endocrine
weight gain
sexual dysfunciton
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5
Q

Tardive dyskinesia

A

abnormal, involuntary orofacial movements

DON’T give anticholinergics

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6
Q

EPS symptoms

A

parkinsonism
dystonia
akathisia
tardive duskinesia

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7
Q

parkinsonism

A

bradykinesia, rigidity, tremor, akinesia

responses to anticholinergics (diphenhydramine, trihexyphenidyl,bentropine)

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8
Q

dystonia

A

torticollis, larynogospasm

give anticholinergics

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9
Q

akathisia

A

somatic restlessness, inability to stay calm

esp. in legs

responds poorly to anticholinergics – B-blockers instead

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10
Q

endocrine S.e. of antipsychotics

A

prolactin secretion

galactorrhea, menstrual changes

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11
Q

NMS

A

any drug causing dopamine antagonism

hyperthermia, muscle rigidity, encephalopathy, autonomic instability

elevated CK from muscle rigidity

dantrolene given to decrease muscle rigidity (hepatotoxic)

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12
Q

TOP FGA (5)

A
  1. Chlorpromazine
  2. Fluphenazine (Prolixin)
  3. Haloperidol (Haldol)
  4. Loxapine
  5. Thiothixene
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13
Q

IM FGA

A
  1. Chlorpromazine
  2. Fluphenazine (Prolixin)
  3. Haloperidol (Haldol)
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14
Q

LAI FGA

A

Fluphenazine (Prolixin)

Haloperidol (Haldol)

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15
Q

oral FGA

A

loxapine

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16
Q

t or f IV Haldol is common practice

A

FALSE

although seen, not FDA approved
QTc prolongation S.e.

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17
Q

FGA s.e. trends

A

most of the FGAs cause weight gain

more EPS and prolactin elevation

18
Q

chlorpromazine s.e.

A

hypercholesterolemia (highest of FGA)
anticholinergics s.e.
othrostatic hypotension

therefore least likely to be used

19
Q

highest cause of anticholinergic s.e. and othrostatic hypotension of FGA

A

thiothixene

20
Q

Haloperidol
(Fluphenazine)

brand

A

Haldol

Prolixin

21
Q

SGA main

A
  1. Aripiprazole (abilify)
  2. Lurasidone (Latuda)
  3. Olanzapine (Zyprexa)
  4. Paliperidone (invega)
  5. Quetiapine (Seroquel)
  6. Risperidone (Risperidal)
  7. Ziprasidone (Geodon)
  8. Clozapine
22
Q

LAI SGA

A

Aripiprazole (abilify)
Risperidone (Risperidal)
Paliperidone (invega)

23
Q

IM SGA

A

Olanzapine (Zyprexa)
Aripiprazole (abilify)
Ziprasidone (Geodon)

24
Q

SGA most likely to cause EPS/Prolactin elevation

A

paliperidone

risperidone

25
Q

SGA with highest weight gain/hypercholesteremia

A

clozapine

olanzapine (Zyprexa)

26
Q

antipsychotics and QTc prolongation

A

IV Haldol

Ziprasidone

27
Q

Aripiprazole

28
Q

Lurasidone

29
Q

Olanzapine

30
Q

Paliperidone

31
Q

Quetiapine

32
Q

Risperidone

A

(Risperidal)

33
Q

Ziprasidone

34
Q

aripiprazole MOA

A

dopamine D1 and 5HT1 agonist
5HT2 antagonist

serotonin activity and dopamine activity

35
Q

lurasidone/latuda beneficial efects

A

theorized to have beneficial cognitive and anxiolytic effects

36
Q

acute agitation

A

FGA and SGA are of equal efficacy

use with benzos

37
Q

CATIE trial

A

difference in effectiveness between FGA and SGA are not as much as we thought

38
Q

PORT recommendations

A

for first episode of schizophrenia

use any other agent but clozapine

39
Q

pregnancy and antipsych

A

clozapine/olanzapine can cross into the breast milk

40
Q

geriatric and antipsych

A

avoid sedation and othrostatic hypotension

more prone to QTc

KC2017 Behavioral Health (11 decks)

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