Flashcards in Dr. Aebi's Schizophrenia and Bipolar Disorder Deck (120)
first generation antipsychotic
What are the treatment goals of schizophrenia treatment?
- Decrease symptoms
- increase quality of life (minimize adverse effects from treatment)
- encourage adherence
- decrease hospitalizations/health care $
Out of the FGAs, what reduces positive symptoms the best?
All FGAs reduce positive symptoms at equivalent doses.
How the FGAs handle negative symptoms?
Do not reduce negative symptoms well.
What are the general positives and negatives to FGA treatment?
EPS is a higher risk, as well as anticholinergic SEs
Lower risk for metabolic syndrome/weight gain
How do SGAs handle positive and negative symptoms of schizophrenia?
Handles positive symptoms well (but not as good as FGAs) and has moderate efficacy at reducing negative symptoms.
What are the benefits in using SGAs over FGAs?
- Possible effect on increasing cognition (hits serotonin receptors: 5HT7 Lurasidone)
- Less EPS because of 5HT2 antagonism in nigrostriatal dopamine pathway
What is the disadvantage in using SGAs over FGAs?
Higher risk for weight gain/metabolic syndrome
What are some negative symptoms in schizophrenia?
Depression, apathy, anhedonia
How is D2 affinity related to potency in FGAs?
The higher the D2 affinity, the more potent the drug is.
What is the range for effectiveness in affinity of the drug for dopamine receptor?
60% to see effectiveness. higher than 80% you start seeing AEs
How are FGAs dosed?
Dosed based on chlorpromazine equivalents
What is the normal range of CPZ equivalents?
300-1000mg CPZ equivalents
In the FGAs, what do the drugs with low mg strength also have?
Higher potency, higher D2 affinity, high EPS, low sedation, and low anticholinergic effects.
In FGAs, what do the drugs with the high mg strength also have?
lower potency, lower EPS risk, lower D2 affinity, higher sedation, higher anticholinergic SEs.
What drugs have lower mg strength?
Haloperidol, Fluphenazine, trifluoroperazone
What drugs have high mg strength?
What drug is used for tourette's?
pimozide and delusional parasitosis
Out of the SGAs, which has the lowest risk of EPS?
clozapine and quetiapine. Also, olanzasine, ziprasidone, and asenapine have low risk.
Which has the highest sedation of the SGAs?
also clozapine and quetiapine
Which has the highest hypotension risks? The lowest hypotension risks?
Clozapine has the highest hypotension risk, lurasidone and ziprasidone the least.
Which has the most weight gain SE's of the SGAs? The least?
most: clozapine and olanzapine
least: aripiprazole, asenapine, risperidone, and ziprasidone
Which SGA has the lowest sedation?
Aripiprazole, lurasidone, paliperidone, risperidone, ziprasidone
Which SGAs have QT prolongation problems?
paliperidone, olanzapine, quetiapine, risperidone, ziprasidone
Which SGA's do not have many QT problems?
Which SGAs increase prolactin levels the most?
olanzapine, paliperidone, risperidone, lurasidone, and ziprasidone
What is the best way to reduce side effects?
Start low, titrate slowly
What are the main long-term side effects to watch out for?