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PHRM 845 > Antipsychotics Ott > Flashcards

Antipsychotics Ott Flashcards

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1
Q

onset of schizophrenia in males and females

A

males - late teens early 20s
women - late 20s early 30s

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2
Q

smoking is associated with induction of ____ because of ____

A

1A2, hydrocarbons

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3
Q

what to do if pt smokes and takes a 1A2 substrate

A

increase the dose

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4
Q

most commonly used typical antipsychotic

A

haloperidol, can be used PRN

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5
Q

which antipsychotics are partial agonists

A

aripipraozole
bexiprazole
cariprazine

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6
Q

partial agonists are associated with increased what

A

akathasia, low weight gain

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7
Q

partial agonists are approved for ajunct treatment in what?

A

depression, box warning suicide

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8
Q

aripiprazole is a ____ substrate

A

2D6 and 3A4

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9
Q

bexiprazole is a ____ substrate

A

2D6 and 3A4

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10
Q

cariprazine is a ____ substrate

A

3A4

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11
Q

which drug has a patch and sublingual formulation?

A

asenapine

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12
Q

asenapine is a substrate of ___

A

1A2

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13
Q

asenapine has ____

A

QTC prolongation

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14
Q

clozapine is a _____substrate

A

1A2

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15
Q

boxed warnings for clozapine

A

neutropenia, orthostasis, bradycardia, syncope, seizures, myocarditis, cardiomyopathy

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16
Q

clozapine side effects

A

sedation, constipation, weight gain, hypersalivation, dry mouth, GI hypomotility,

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17
Q

drugs with QTC prolongation

A

asenapine, clozapine, quetiapine, iloperidone, ziprasidone, paliperidone

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18
Q

olanzapine is a ____ substrate

A

1A2

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19
Q

olanzapine side effects

A

weight gain and sedation
DRESS warning

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20
Q

quetiapine is a _____substrate

A

3A4

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21
Q

quetiapine side effects

A

weight gain and sedation
suicide ideation

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22
Q

asenapine patch should be applied every

A

24 hours, rotate sites

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23
Q

clozapine REMS

A

absolute neutrophil count
monitoring weekly x 6 months
biweekly x 6 months
then every 4 weeks

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24
Q

what drug is the combo opioid antagonist

A

olanzapine/samidorphan
mu opioid activity

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25
iloperidone risks
orthostasis and syncope
26
iloperidone is a _____ substrate
2D6
27
lurasidone is a ____ substrate
3A4
28
lurasidone risks
akathasia, suicidal
29
which should be taken with food
lurasidone and ziprasidone
30
ziprasidone is a _____ substrate
3A4 and aldehyde oxidase
31
risperidone is a ______ substrate
2D6 (3a4 minor)
32
risperidone side effects
EPS, hyperprolactinemia, weight gain, sedation, orthostatis
33
paliperidone side effects
similar to risperidone
34
which drug renally eliminated
paliperidone
35
lumateperone (Capylta) is a ____ substrate
3A4
36
lumateperone side effects
low risk for weight gain, akathesia, EPS
37
pimavanserin use
hallucinations in Parkinsons disease inverse agonist and antagonist and serotoni 5HT2A
38
pimavanserin is a ____ substrate
3A4
39
which drug must be Z tracked, is long acting for 4 weeks
haloperiodol
40
Risperdal consta requirements
must supplement with oral risperidone for first 4 weeks of treatment
41
what is Perseris and where does it go
risperidone injection abdominal subq injection
42
what is Rykindo and dosing
risperidone injection every 2 week injection oral dose overlap is only 7 days
43
what is Uzedy and dosing
risperidone injection abdominal or upper arm subq given once every month or 2 months
44
what is Invega Sustenna and dosing given in _____
paliperidone loading then booster then every 4 weeks loading and booster given in deltoid
45
does Invega need oral overlap
no, if we have loading
46
Invega sustenna has ____ elimination
renal
47
Invega Trinza can be given when
if at least 4 stable invega sustenna doses
48
Invega Trinza given in ____
deltoid
49
Invega Trinza not recomended in _____
CrCl < 50 mL/min
50
what is Invega Trinza
paliperidone q3 months
51
what is Invega Hafyera
paliperidone q6 months
52
when can we give Invega Hafyera
sustenna - 4 months OR trinza - one 3 month dose
53
Invega Hafyera is a ____ injection
gluteal
54
Zyprexa Relprevv risk
PDSS - post dose delirium sedation syndrome
55
Zyprexa Relprevv is what drug
olanzapine
56
abilify maintena and asimtufii requirement
overlap with oral aripiprazole for 14 days after first injection
57
where to administer abilify maintena
deltoid, gluteal
58
when do we need to adjust dose for Abilify Maintena?
if we are taking 2D6 or 3A4 inhibitors or 3A4 inducers for more than 14 days with it
59
Abilify Asimtufii dosing and site
every 2 months, gluteal
60
Aristada requirement
prodrug so overlap with 3 weeks of oral
61
Aristada initio does not need what
overlap of oral for 3 weeks
62
when to avoid Aristada Initio
poor 2D6 metabolizers or with strong 3A4 or 2D6 inhibitors
63
immediate release antipsychotic injections
haloperidol, chlorpromazine, fluphenazine Lozapine for inhalation
64
what can we not give together with olanzapine IM immediate release
benzodiazepines IR, respiratory depression
65
treatment for acute dystonia
anticholinergics IM (benztropine, diphenhydramine)
66
treatment for Parkinsons induced symptoms
anticholinergics PO (benztropine, diphenhydramine, trihexphyenidyl)
67
treatment for akathisia
beta blocker - propranolol benzodiazepine - lorazepam
68
treatment for tardive dyskinesias
VMAT inhibitors
69
VMAT inhibitors
valbenazine deutetrabenazine
70
VMAT inhibitors cause
QTC prolongation
71
valbenazine is a substrate for ___
2D6/3A4
72
deutetrabenazine is a substrate for ___
2D6
73
neuroleptic malignant syndrome is what
life threatening
74
symptoms of NMS
hyperpyrezia, tachycardia, labile bP muscle rigidity, elevated CK
75
is future antipsychotic use contraindicated in NMS
no
76
drugs with highest risk of metabolic issues
clozapine, olanzapine
77
metabolic issues
HTN, hyperglycemia, hyperlipidemia
78
what should we monitor with metabolic
family hx BMI waist BP glucose / a1c lipids fasting
79

PHRM 845 (38 decks)

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