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Meds > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

brand name for aripiprazole

A

abilify

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2
Q

brand name for brexpiprazole

A

rexulti

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3
Q

brand name for cariprazine

A

vraylar

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4
Q

brand name for chlorpromazine

A

thorazine

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5
Q

brand name for clozapine

A

clozaril

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6
Q

brand name for iloperidone

A

fanapt

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7
Q

brand name for haloperidol

A

haldol

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8
Q

brand name for lurasidone

A

latuda

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9
Q

brand name for lumateperone

A

caplyta

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10
Q

brand name for olanzapine

A

zyprexa

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11
Q

brand name for paiperidone

A

invega

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12
Q

brand name for quetiapine

A

seroquel

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13
Q

brand name for risperidone

A

risperidol

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14
Q

brand name for ziprasidone

A

geodon

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15
Q

weight gain with aripiprazole

A

low risk

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16
Q

dosage of aripiprazole for mania and schizophrenia

A

10-30 mg qd

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17
Q

dosage of aripiprazole for augmenting SSRI/SNRI

A

2-10mg qd

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18
Q

FDA approved uses for aripiprazole

A

irritability in autism
schizophrenia
acute/mixed mania
bipolar maintenance
acute agitation

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19
Q

off label uses for aripiprazole

A

bipolar depression and behavioral issues

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20
Q

labs to montir with aripiprazole

A

fasting lipids
fasting glucose
CBC
BMI

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21
Q

which enzymes metabolize aripiprazole

A

3A4
2D6

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22
Q

which drugs decrease concentration of aripiprazole

A

carbamazepine
valproate

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23
Q

weight gain with brexpiprazole

A

more weight gain/sedation than abilify

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24
Q

dosage of brexpiprazole for schizophrenia

A

1-4mg

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25
Q

what enzymes metabolize brexpiprazole

A

2D6
3A4

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26
Q

dosage of brexpiprazole for depression

A

2-4mg

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27
Q

FDA approved uses for brexpiprazole

A

schizophrenia
tx resistant depression

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28
Q

off label uses for brexpiprazole

A

bipolar depression
acute/mixed mania

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29
Q

geriatric considerations for brexpiprazole

A

not with dementia

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30
Q

what labs should be monitored with all antipsyhotics

A

fasting lipids
fasting glucose
CBC
BMI

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31
Q

brexpiprazole side effects v. aripiprazole side effects

A

brexpiprazole has more weight gain but less GI side effects

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32
Q

max dose of brexpiprazole in renal impairment

A

3mg

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33
Q

weight gain with clozapine

A

high

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34
Q

upwards clozapine taper

A

25mg QHS and then increase by 25-50mg q48-72 hours

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35
Q

when do you start obtaining trough plasma levels for clozapine

A

at 200mg

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36
Q

FDA approved uses for clozapine

A

treatment resistant schizophrenia
reduce SI in schizophrenia

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37
Q

additional labs to monitor with clozapine for the first month

A

troponin and CRP weekly

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38
Q

how often should you obtain absolute neutrophil counts with clozapine

A

weekly x 6 months
q2 weeks x6 months
monthly thereafter

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39
Q

contraindications for clozapine

A

myeloproliferative disorder
paralytic ileus
uncontrolled epilepsy
CNS depression

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40
Q

severe side effects of clozapine

A

severe neutropenia
agranulocytosis
myocarditis

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41
Q

how can you prescribe clozapine

A

must be on national registry

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42
Q

what are the biggest advantages to clozapine

A

most effective
TD is rare
decreases SI

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43
Q

dosage for asenapine

A

5-10mg SL BID

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44
Q

FDA approved uses for asenapine

A

negative sx of schizophrenia
bipolar 1

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45
Q

which antipsychotic can be used for prn and why

A

asenapine d/t its fast absorption

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46
Q

asenapine and QT interval

A

2-5 second QT prolongation

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47
Q

asenapine drug interactions

A

nicotine
decreases effectiveness of narcotic pain killers

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48
Q

which meds are contraindicated with asenapine

A

buspirone
vilazodone

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49
Q

starting dosage of iloperidone

A

2mg BID

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50
Q

dosage range for iloperidone

A

12-24mg in divided doses

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51
Q

FDA approved uses for iloperidone

A

schizophrenia

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52
Q

off label uses for iloperidone

A

bipolar maintenance
tx resistant depression

53
Q

what are geriatric considerations for all antipsychotics

A

lower doses
increased risk of death
increased risk of CVA

54
Q

what is an advantage of iloperidone

A

TD is rare

55
Q

when would you avoid iloperidone

A

hepatic impairment
severe cardiac impairment

56
Q

dosage of lurasidone for schizophrenia

A

40-80mg QHS

57
Q

dosage of lurasidone for bipolar

A

20-60mg QHS

58
Q

FDA approved uses for lurasidone

A

schizophrenia
bipolar depression

59
Q

off label uses for lurasidone

A

tx resistant depression

60
Q

what is the preferred antipsychotic to use when taking a pregnant woman off a mood stabilizer

A

lurasidone

61
Q

which antipsychotics have to be tapered down slowly

A

lurasidone
paliperidone
ziprasidone

62
Q

which antipsychotic has to be taken with 350 cal of food for absorption

A

lurasidone

63
Q

weight gain with lumateperone

A

25% lose weight

64
Q

dose for lumateperone

A

42mg qd

65
Q

FDA approved uses for lumateperone

A

schizophrenia
bipolar depression

66
Q

pregnancy considerations for lumateperone

A

not during lactation

67
Q

black box warning on lumateperone

A

dementia related psychosis and suicidality

68
Q

side effect profile of lumateperone

A

low EPS and negative sx

69
Q

weight gain with olanzapine

A

high weight gain

70
Q

PO dosage range for olanzapine

A

5-20mg qd

71
Q

FDA approved uses of olanzapine

A

schizophrenia
acute/mixed mania
bipolar maintenance
acute agitation

72
Q

when is olanzapine used for treatment resistant depression

A

in combination with fluoxetine

73
Q

off label uses for olanzapine

A

combine with naltrexone or metformin for metabolic side effects

74
Q

gender difference in dosage of olanzapine

A

women may need lower doses

75
Q

contraindications for olanzapine

A

angle-closure glaucoma, unstable medical condition

76
Q

advantages of olanzapine

A

high efficacy for class
low QTc issues

77
Q

olanzapine dosage considerations for hepatic/renal impairment

A

start low IM for renal
hepatic start w/ 5mg and get yearly LFTs

78
Q

general dosage range for paliperidone

A

6-12mg qd

79
Q

dosage range for paiperidone with sustenna

A

39-324 monthly

80
Q

dosage of paliperidone with trinza

A

273-819 q3 months

81
Q

FDA approved uses for paliperidone

A

schizophrenia
schizoaffective disorder
bipolar

82
Q

what must you remember when starting IM paliperidone

A

start with PO first then switch over

83
Q

major disadvantage to paliperidone side effects

A

dose-dependent EPS
hyperprolactinemia

84
Q

contraindications for paliperidone

A

other meds than prolong QT interval
hx of arrhythmia
recent MI
preexisting severe GI narrowing

85
Q

paliperidone dosage adjustment for renal impairment

A

mild = max dose of 6mg
mod-severe = max dose 3mg

86
Q

weight gain with quetiapine

A

moderate weight gain
less with ER formulation

87
Q

dosage range for quetiapine

A

150-800mg qd

88
Q

FDA approved uses for quetiapine

A

schizophrenia, mania, bipolar maintenance, adjunct for depression

89
Q

quetiapine dosage adjustment for elderly

A

25-100mg BID

90
Q

which antipsychotic is preferred for parkinson’s psychosis and lewy body dementia

A

quetiapine

91
Q

which mood stabilizer does quetiapine interact with

A

depakote

92
Q

weight gain with risperidol

A

moderate

93
Q

initial dosage and titration of risperidone

A

1mg qd divided in 2 doses then increase by 1mg daily

94
Q

dosage range for risperidone

A

2-8mg

95
Q

FDA approved uses for risperidol

A

schizophrenia
other psychotic disorders
acute/mixed mania
bipolar maintenance
irritability in autism

96
Q

risperidone dosage adjustment for elderly

A

0.5mg intially then 1mg BID

97
Q

additional labs to monitor with risperidone

A

prolactin levels
EKG

98
Q

risperidone dosage adjustment for renal/hepatic impairment

A

0.5mg BID x1 week then 1mg BID

99
Q

what dosage does risperidone have a high risk of EPS

A

> 6mg

100
Q

weight gain with ziprasidone

A

less weight gain
take with food

101
Q

dosage of ziprasidone for schizophrenia

A

20-40mg BID
max 200mg qd

102
Q

dosage of ziprasidone for bipolar

A

initial 40mg BID
max 160mg qd

103
Q

FDA approved uses for ziprasidone

A

schizophrenia
acute/mixed mania
bipolar maintenance
acute agitation

104
Q

which antipsychotic prolong QT interval the most

A

paliperidone
ziprasidone

105
Q

what antipsychotics have to be tapered to dc

A

ziprasidone
lurasidone
paliperidone

106
Q

contraindications for ziprasidone

A

other QT prolongating meds
hx QTc prolongation or arrhtythmia
HF
MI

107
Q

which atypical antipsychotics have the most weight gain

A

olanzapine
clozapine

108
Q

indications for clozapine other than previous tx failures

A

severe TD
low threshold for EPS

109
Q

which antipsychotics are approved for bipolar maintenance

A

aripiprazole
olanzapine
quetiapine

110
Q

which antipsychotics are used to tx aggression and self-injury in children

A

risperidone
olanzapine

111
Q

which receptors does risperidone have antagonist action

A

5HT2A
D2
a1-adrenergic
a2-adrenergic
H1

112
Q

common side effects of risperidone

A

weight gain
anxiety
N/V
rhinitis
ED
anorgasmia
increased pigmentation
sedation

113
Q

which enzyme metabolizes risperidone

A

2D6

114
Q

risperidone with SSRIs

A

marked elevation in prolactin levels

115
Q

recommended dosage of risperidone

A

6mg NTE 12mg daily

116
Q

which antipsychotics are available in depot

A

risperidone
paliperidone
olanzapine

117
Q

what enzymes is olanzapine a substrate for

A

1A2
2D6

118
Q

what cannot be coadministered with olanzapine

A

benzodiazepines

119
Q

quetiapine is a substrate for which enzyme

A

3A4

120
Q

which antipsychotic is not associated with EPS

A

seroquel

121
Q

what med increases seroquel clearance 5 fold

A

phenytoin

122
Q

which enzyme metabolizes geodon

A

3A4

123
Q

absorption when geodon is taken with food

A

doubled

124
Q

which enzymes metabolize clozapine

A

mainly 1A2
less by 2D6 and 3A4

125
Q

WBC that contraindicates clozapine

A

<3500

126
Q

which enzymes metabolize iloperidone

A

2D6
3A4

127
Q

what enzyme metabolizes lurasidone

A

3A4

128
Q

which enzymes metabolize lumateperone (Caplyta)

A

1A2
3A4

129
Q

how long should you leave the stabilization dose the same after an acute episode of psychosis

A

3-6 months

Meds (11 decks)

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