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NAPLEX review 2024 RXPrep Book > Psychiatric Conditions: Schizophrenia/ Psychosis > Flashcards

Psychiatric Conditions: Schizophrenia/ Psychosis Flashcards

1
Q

Common Schizophrenia symptoms

A

Hallucinations
Delusions
Disorganized thinking/belief

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2
Q

Negative Schizophrenia symptoms

A

Loss of interest in everyday activities
Lack of emotion (apathy)
inability to plan or carry out activities
poor hygiene
Social withdrawal
Loss of motivation
Lack of speech

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3
Q

Positive Schizophrenia symptoms

A

Hallucinationos
Delusions
Disorganized thinking/behavior
Difficulty paying attention

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4
Q

1st line txm for Schizophrenia

A

second send antipsychotics, less EPS

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5
Q

Antipsychotics in elderly patients

A

not indicated for agitation control in elderly patients with dementia related psychosis
inc risk of mortality

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6
Q

First Gen antipsychotics

A

Low Potency = Chlorpromazine, Thioridazine
Mild potency = Loxapine (adasuve = inhalation), Perphenazine
High Potency = Haloperidol, Fluphenazine, Thiothixene, Trifluoperazine

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7
Q

FGA boxed warnings

A

Elderly pts w/ dementia related psychosis
Thioridazine = QT prolong
Adasuve = REMS for bronchospasm

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8
Q

FGA warnings

A

Cardiovascular effects: QT prolongation, tachycardia
Anticholinergic effects
EPS
Hyperprolactinemia
Neuroleptic malignant syndrome (NMS)
blood dyscrasias

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9
Q

FGA side effects

A

Sedation
dizziness
anticholinergic effects
EPS

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10
Q

FGA notes

A

Lower potency = inc sedation, less EPS
Higher potency = dec sedation, more EPS

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11
Q

Second Gen antipsychotics

A

Aripiprazole = Abilify
Clozapine = Clozaril
Lurasidone = Latuda
Olanzapine = Zyprexa
Paliperidone = Invega
Quetiapine = Seroquel
Risperidone = Risperdal
Ziprasidone = Geodon

Asenapine = Saphris
Brexpiprazole = Rexulti
Cariprazine = Vraylar
ILoperidone = Fanapt
Lumateperone = Caplyta

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12
Q

Aripiprazole (Abilify) side effects

A

Akathisia, activating or sedating, headache, anxiety, constipation

lower risk of weight gain, some QT prolong, EPS

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13
Q

Clozapine (Clozaril) boxed warings

A

sig risk of neutropenia/arganulocytosis (REMS program)
Myocarditis and cardiomyopathy
seizures = dose related

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14
Q

Clozapine (Clozaril) side effects

A

Agranulocytosis, seizures, constipation, somnolence, metabolic syndrome (inc weight/BG/lipids), hypersalivation

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15
Q

Clozapine (Clozaril) monitoring

A

REMS, pharmacy/prescriber have to be certified and pt enrolled

baseline ANC > 1,500, weekly checks X 6 months, then bi weekly X 6 months, then monthly.
Stop if ANC < 1,000

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16
Q

Lurasidone (Latuda) Contraindications

A

Strong CYP450 3A4 inducers/inhibitors

17
Q

Lurasidone (Latuda) side effects

A

Somnolence, EPS (dystonia), Nausea

lower risk of metabolic syndrome, lower effect on weight/BG/Lipids

18
Q

Olanzapine (Zyprexa) Boxed warnings

A

Injection have to monitor for 3hrs and given in Health care facility, REMS program

19
Q

Olanzapine (Zyprexa) side effects

A

Somnolence
metabolic syndrome = inc weight/BG/lipids

20
Q

Zyprexa Relprevv

A

inject that last 2-4 weeks
REMS program
restricted use

21
Q

Paliperidone (Invega) side effects

A

inc prolactin = sexual dysfunction
EPS, especially at higher doses
tachycardia, QT prolong
metabolic syndrome = inc weight/BG/lipids
somnolence

22
Q

Quetiapine (Seroquel) side effects

A

Somnolence, metabolic syndrome
Low EPS risk, often used in Parkinson’s patients

XR = take w/o food, or with light meal

23
Q

Risperidone (Risperdal) Side effects

A

inc prolactin = sexual dysfunction
EPS, especially at higher doses
tachycardia, QT prolong
metabolic syndrome = inc weight/BG/lipids
Somnolence

24
Q

Ziprasidone (Geodan) Contraindications

A

QT prolong, dont use if QT risk

25
Q

Ziprasidone (Geodan) side effects

A

Somnolence, dizziness, nausea, EPS

26
Q

Asenapine (Saphris) Contraindications and Side effects

A

CI: sever hepatic impairment

Side effects: Tongue numbness (w/ sublingual), somnolence, EPS, AT prolong

27
Q

Psychosis in parkinson txm

A

Pimavanserin (Nuplazid)

28
Q

Pimavanserin (Nuplazid) warnings and Side effects

A

Warnings: QT prolong, not approved for dementia related psychosis
Side effects: Peripheral edema, confusion

29
Q

Smoking effect on antipsychotics

A

can reduce lvls and need higher doses of antipsychotics

ie. Olanzapine and clozapine

30
Q

Tardive dyskinesia medicatons

A

Valbenazine (Ingrezza)
Deutetrabenazine (Austedo)

31
Q

Valbenazine (Ingrezza) warnings

A

somnolence
QT prolong

32
Q

Deutetrabenazine (Austedo) Contraindications and warnings

A

CI: hepatic impairment, MAOi within 14 days
Warnings: Somnolence, Qt prolong

33
Q

NMS signs

A

hyperthermia
extreme muscle rigidity
mental status change
tachycardia, tachypnea, BP changes

34
Q

Txm of NMS

A

stop antipsychotic and provide supportive care

relax muscle, can use benzodiazepines, dantrolene or dopamine agonist (bromocriptine)

switch antipsychotics after resolution

NAPLEX review 2024 RXPrep Book (71 decks)

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