11 - Psychoses Flashcards Preview

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Flashcards in 11 - Psychoses Deck (27):
1

List some low potency FGAs

chlorpormazine or methotrimeprazine

2

List some intermediate potency FGAs

loxapine or perphenazine

3

List some high potency FGAs

haloperidol or fluphenazine

4

What s/e are low potency FGAs more likely to cause?

have increased rates of sedation, CV effects, anticholinergic s/e and weight gain

5

What s/e are high potency FGAs more likely to cause?

higher rates of EPS, NMS, and increased prolactin levels

6

_____ is for tx-resistant schizophrenia

clozapine

7

What is an adequate trial for antipsychotics?

4-8 weeks @ therapeutic dose

8

How long should you treat for?

min 1-2 years

For those with 2 or more episodes, treat for 5 years (stable and disease recurrence-free for 5 years)

9

Key counselling points for:
Aripiprazole (SGA)

-given in morning as it can cause insomnia
-changes in dosage should be made no more frequently than every 14 days due it's uniquely long half life

10

Key counselling points for:
Asenapine (SGA)

-given SL
-can cause hypoesthesia and paresthesia, usually resolve within 1 hour
-can cause hypersensitvity reactions

11

Key counselling points for:
Brexpiprazole (SGA)

low risk of akathisia and EPS, weight gain and metabolic complications

12

Key counselling points for:
Lurasidone (SGA)

-need to take with food (min 350 calories)
-can cause significant nausea! (give dose HS or ginger or peppermint may be helpful)

13

Key counselling points for:
Paliperidone (SGA)

-active metabolite of risperidone
-can cause insomnia so give in morning

14

Key counselling points for:
Ziprasidone (SGA)

-need to take with food (min 500 calories)
-only agent to show improvement in weight and metabolic parameters following a switch from another SGA

15

Smoking induces metabolism of which antipsychotics

clozapine
olanzapine

16

How long should you taper for before discontinuing?

-gradually reduce the dose by < 20% every 2-4 weeks
-reduce over a period of 6-12 months for first episode patients and 6-24 months if patients have experienced 2 or more episodes

17

What is NMS syndrome?

muscle rigidity, fever, autonomic disturbance, labile (easily changed) blood pressure, fluctuating levels of consciousness and elevated levels of CK and WBC

18

What is a risk factor for NMS?

dehydration

19

What antipsychotics cause sedation?

low potency FGAs, clozapine, olanzapine, quetiapine

20

____ can cause a dulling effect

FGAs

21

What is the major advantage of using SGAs over FGAs?

less incidence of EPS

22

What is tardive dyskinesia?

repetitive, involuntary choreoathetoid movements usuallly involving the buccal-oral-lingual musculature, face, trunk, extremeties, or respiratory muscles and can be permanent and disabling

23

____ may improve existing TD

clozapine

24

What drugs can cause dyslipidemia?

clozapine, olanzapine and quetiapine

*can manage this by switching to ziprasidone

25

What drugs can cause QT prolongation?

-ziprasidone
-haloperidol
-chlorpromazine, pimozide

26

____ can cause myocarditis

clozapine

27

_____ can cause DRESS

olanzapine

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