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Pharmacotherapy 3 Exam 1 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Diagnosis of schizophrenia requires two or more of the following symptoms

A

Delusions, hallucinations, or disorganized speech over a period of 6 months

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2
Q

___ is a neurotransmitter that slows the progression of schizophrenia

A

Nicotine. Dopamine is the other neurotransmitter that plays a role in schizophrenia

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3
Q

In schizophrenia, the ___ region of the brain regulates emotions. ___ of this region produces symptoms of schizophrenia

A

Mesolimbic

Hyperactivity

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4
Q

In schizophrenia, the ___ region of the brain regulates cognitive functioning. ___ of this region produces cognitive deficits

A

Mesocortical

Hypoactivity

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5
Q

In schizophrenia, the ___ region of the brain regulates motor activity. ___ of this region produces tics and dyskinesia

A

Nigrostriatal

Hyperactivity

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6
Q

In schizophrenia, the ___ region of the brain inhibits prolactin. ___ of this region increases prolactin and causes amenorrhea in females and gynecomastia in males

A

Tuberoinfundibular

Hypoactivity

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7
Q

Be able to recognize the second generation (atypical) antipsychotics

A 
Aripiprazole (Abilify)
Asenapine (Saphris)
Brexpiprazole (Rexulti)
Cariprazine (Vraylar)
Clozapine (Clozaril)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Paliperidone (Invega)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
***You do not need to know brand names
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8
Q

What are the maximum doses of aripiprazole, olanzapine, and quetiapine

A 
Aripiprazole = 30mg
Olanzapine = 20mg
Quetiapine = 800mg
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9
Q

Which 3 atypical antipsychotics are partial agonists

A

Aripiprazole
Brexpiprazole
Cariprazine

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10
Q

All antipsychotics block ___ receptors

A

Dopamine

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11
Q

Atypical antipsychotics block dopamine and ___ receptors

A

Serotonin

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12
Q

Side effects (specifically extrapyramindal side effects) are generally more likely with high potency antipsychotics, such as ___ or ___

A

Haloperidol

Fluphenazine

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13
Q

What medications are used to treat pseudoparkinsonism (“pill-rolling”, tremor, rigidity)?

A

Benztropine
Trihexyphenidyl
Diphenhydramine

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14
Q

What medications are used to treat dystonias (twisting of the neck)?

A

Benztropine
Trihexyphenidyl
Diphenhydramine

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15
Q

What medications are used to treat akathisia (restlessness)?

A

Propranolol

Lorazepam

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16
Q

What medications are used to treat tardive dyskinesia (grimacing, worm-like movement of the tongue)?

A

Removal or reduction of offending agent
Valbenazine
Deutetrabenazine (If associated with Huntington’s Disease)

17
Q

Deutetrabenazine has a BBW of ___ and ___

A

Depression and suicide

18
Q

What two medications are VMAT 2 Inhibitors?

A

Valbenazine

Deutetrabenazine

19
Q

What are side effects of VMAT 2 Inhibitors and what medications are used to treat those side effects?

A

Neuroleptic Malignant Syndrome (NMS) -
Symptoms include hyperthermia, “cogwheeling”, rhabdomyolysis, diaphoresis
Treat with bromocriptine or dantroline (these increase dopamine)

20
Q

What is the BBW for antipsychotics?

A

Increased mortality in elderly

21
Q

What were the results of the CATIE trial?

A

Olanzapine is moderately more effective than other atypical antipsychotics and all conventional (1st generation) antipsychotics

Follow-up study showed clozapine to be superior to all other agents in “treatment-resistant schizophrenia”

22
Q

What is the first line treatment for schizophrenia?

A

Atypical antipsychotic

23
Q

What is the second line treatment for schizophrenia?

A

Switch to a different atypical antipsychotic or consider a conventional antipsychotic

24
Q

What is the third line treatment for schizophrenia?

A

Consider clozapine

25
Q

What is the fourth line treatment for schizophrenia?

A

Consider adding a second agent or ECT to existing clozapine regimen

26
Q

Which atypical antipsychotics cause the most weight gain?

A

CLOZAPINE, OLANZAPINE, paliperidone, quetiapine, risperidone

27
Q

What are the 3 major side effects of clozapine?

A

Weight gain, anticholinergic, orthostasis

May or may not cause extrapyramidal symptoms

28
Q

Which atypical antipsychotics cause the most EPS?

A

Asenapine, paliperidone, risperidone

29
Q

Which atypical antipsychotic may cause weight gain OR weight loss?

A

Ziprasidone

30
Q

Which atypical antipsychotics cause the most orthostasis?

A

CLOZAPINE, iloperidone, quetiapine

31
Q

Aripiprazole, brexpiprazole, and cariprazine can cause increased incidence of ___

A

Akathisia

32
Q

What three atypical antipsychotics have the greatest risk for sedation and metabolic effects?

A

Cariprazine, clozapine, and olanzapine

33
Q

Clozapine requires blood monitoring. What is the target drug concentration in order to reduce the risk of adverse effects?

A

350-400 mcg/mL

34
Q

A dose of clozapine > 600mg can cause ___

A

Seizures

35
Q

Sedation, coma, and death have been associated with injectable forms of ___

A

Olanzapine

36
Q

A common effect of quetiapine is ___

A

Sedation - due to anticholinergic properties

think “quiet nap”

37
Q

Ziprasidone has a BBW for ___

A

Cardiac abnormalities

38
Q

IM olanzapine CANNOT be given with IM ___

A

Lorazepam

Pharmacotherapy 3 Exam 1 (6 decks)

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