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MRCPSYCH Paper B _ Mainly general Adult (mentor&more) > Adverse Events -Antipsychotics- Maudsley > Flashcards

Adverse Events -Antipsychotics- Maudsley Flashcards

(54 cards)

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1
Q

Antipsychotic (AP) with least sedation? (Very low -)

A

Amisulpride -

Aripiprazole -

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2
Q

AP with most sedation ( High incidence +++)

A

Clozapine +++

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3
Q

AP with some moderate sedation

A

Olanzapine ++
Quetiapine ++
Zuclopenthixol ++

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4
Q

AP with Most weight gain AEs

A

Clozapie +++
Olanzapie +++

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5
Q

AP with Least weight gain

A

Aripiprazole +/-

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6
Q

AP with with moderate weight gain

A

Zuclopenthixol ++
Risperidone ++
Quetiapine ++
Paliperidone ++
Flupentixole ++
Chlopromazine ++

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7
Q

AP with +++ for diabetes?

A

Clozapine +++
Olanzapine +++

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8
Q

AP with ++ (moderare incidence) of diabetes

A

Quetiapine

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9
Q

AP with - (very low) incidence of diabetes

A

Aripirazole (Aro30)
Pimozide

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10
Q

AP with +++ of EPSE

A

Haloperidol +++
Fluphenazin +++

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11
Q

AP with ++ of EPSE

A

Zuclopenthixol ++
Flupentixol ++

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12
Q

AP with - of EPSE

A

Clozapine

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13
Q

AP with +++ of anticholinergic AEs (Adverse events)

A

Clozapine

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14
Q

AP with - anticholinergic

A

Aripiprazole (Aro30)
Asenapine
Amisulpride (I miss 1200)

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15
Q

AP with - (very low incidence) of postural hypotension

A

Amisulpride ( I miss 1200) -
Asenapine -
Aripiprazole (Aro30) -

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16
Q

AP with High incidence (+++) of postural hypotension

A

Clozapine (900 clues open)

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17
Q

Most commonly shared AEs in 1st gen APs

A

Prolactine elevation

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18
Q

AP with - of prolactine elevation?

A

Quetiapine

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19
Q

Likely cause for weight gain in AP

A

Increase appetite and decreased activity

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20
Q

Mechanisms behind inc. in weight after taking APs:

A

***Increase in

Ghrelin
Leptin
Prolactin

***Antagonism of
D2 &D3
2A &2C (5-HT)
H1 &M3

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21
Q

Management of weight gain according to Maudsley

A

Calorie restriction
low glycemic index
Exercise

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22
Q

What if exercise and food restriction did not work in AP induced weight gain?

Study These Flashcards
A

Aripiprazol
Ziprasidone
Lurasidone

23
Q

Additional recommendation for AP induced weight gain

Study These Flashcards
A

_Aripiprazole augmentation
_Metformin
_Orlistat
_Liraglutide
_Topiramate

24
Q

When aripirazole augment is recommended in AP induced weight gain?

Study These Flashcards
A

In Olan and Clozapine induced weight gain

25
When Liraglutde is recommended for AP induced weight gain?
For clozapine induced weight gain
26
Rate of Tardive dyskinesia (TD) affecting face (typically)
3/4
27
Rate of Tardive dyskinesia (TD) affecting trunk (typically)
1/4
28
Rate of Tardive dyskinesia affecting Limb (typically)
1/2
29
Effect of emotional arousal on Tardive Dyskinesia
Increase
30
Effect of relaxation on TD
decrease
31
Effect of sleep on TD
disappear
32
Effect of Voluntary Muscle Movement on TD
decrease
33
Effect of mental arithmetic on TD
worsen
34
True or false Increase dose of neuroleptic may lessen the TD severity
True
35
True or False Anticholinergics will make TD worse
True
36
when does TD starts after start of neuroleptics
months to years
37
when can TD start earlier after initiation of neuroleptics?
in elderly in a month
38
is it possible for TD to occur in treatment naive schizophrenia patient?
yes
39
significance of TD in Rx naive schizophrenia?
might be a symptom of schizo pathology
40
Course of TD
fluctuating with some spontaneous remission
41
Effect of reduction in psychotic drugs (sometimes)
unmasking TD
42
Most persistent hypothesis for TD development
Post synaptic D2 hypersensitivity
43
other hypothesis for TD development
Cholinergic interneuron burnout hypothesis Presynaptic dopaminergic/noradrenergic hyperactivity Excitatory/oxidative stress hypothesis Synaptic plasticity hypothesis
44
non-modifiable Risk factors for TD
Advance Age Female Ethnicity (white and africans) Longer illness duration Intellectual disability Brain damage Negative symptoms in schizophrenia Mood disorders
45
Modifiable risk factors for TD
Diabetes Smoking Alcohol & subs. misuse FGA vs SGA Rx Higher antipsychotic dose akathisia
46
Rx of TD
stop anticholinergic - poor support by evidence Reduce antipsychotics - poor support by envidence Change to safe antipsychotic
47
which antipsychotic is safer for TD?
Clozapine
48
alternative to clozapine for antipsychotics safe for TD
Olan, QUe and Aripiprazole
49
addon options to Rx TD
Tetrabenazine Vitamin E Amantadine (RareEly used but affective)
50
what do evidence show about vitamin E in Rx of TD?
slowing the rate
51
what is tertrabenzine?
VMAT-2 inhibitor vesicular monoamine transporter inhibitor
52
where is tetrabenazine is used ?
chorea in huntington
53
what do VMAT-2 inhibitors do?
depletion of dopamine in nerve terminals
54
the only Rx licensed for TD in the UK
tetrabenazin

MRCPSYCH Paper B _ Mainly general Adult (mentor&more) (92 decks)

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