Schizophrenia

Question 1

treatment for first episode of psychosis

Answer 1

oral antipsychotic and psychological treatment (CBT)

Question 2

second generation antipsychotics examples

Answer 2

clozapine
risperidone
olanzapine
quetiapine
amisulpiride
aripiprazole

Question 3

First generation antipsychotics- Phenothiazines group 1 examples

Answer 3

chlorpromazine
levomepromazine
promazine
- all end in ‘promazine’

Question 4

First generation antipsychotics- Phenothiazines group 2 examples

Answer 4

pericyazine
- lowest EPS side effects

Question 5

First generation antipsychotics- Phenothiazines group 3 examples

Answer 5

fluphenazine
prochlorperazine
trifluoperazine
- end in ‘perazine’
- strongest EPS side effects

Question 6

butyrophenones examples

Answer 6

benperidol
haloperidol
- strong EPS side effects

Question 7

antipsychotic high risk of sedation

Answer 7

Clozapine and chlorpromazine
- think integrated report

Question 8

antipsychotic low risk of sedation

Answer 8

amisulpiride and aripiprazole
- think second gen As

Question 9

antipsychotic high risk of EPSE’s

Answer 9

Haloperidol

Question 10

antipsychotic low risk of EPSE’s

Answer 10

quetiapine, aripiprazole And clozapine

Question 11

antipsychotic high risk of anticholinergic Side effects

Answer 11

Clozapine

Question 12

antipsychotic low risk of anticholinergic

Answer 12

aripiprazole and amisulpiride

Question 13

antipsychotic high risk of QT prolongation

Answer 13

Haloperiodol

Question 14

antipsychotic low risk of QT prolongation

Answer 14

Aripiprazole

Question 15

antipsychotic high risk of postural hypotension

Answer 15

Aripiprazole, risperidone, clozapine, quetiapine

Question 16

antipsychotic high risk of stroke

Answer 16

Risperidone and olanzapine (stROke)

Question 17

High risk of hyperglycaemia

Answer 17

risperidone, olanzapine, clozapine, quetiapine (ROCQ)

Question 18

high risk of weight gain

Answer 18

Clozapine and olanzapine (COw)

Question 19

low risk of hyperprolactinaemia

Answer 19

clozapine, olanzapine, quetiapine, aripiprazole

Question 20

When is clozapine indicated?

Answer 20

Treatment resistant schizophrenia
- Lack of satisfactory clinical improvement despite the use of adequate doses of at least two different antipsychotic agents, including an atypical antipsychotic agent, prescribed for adequate duration (≥6 weeks)

Question 21

What is the MHRA alert surrounding clozapine?
- what symptom would be a cause to seek medical attention

Answer 21

Potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus
- seek medical attention if constipation occurs

Question 22

How can constipation be managed with clozapine?

Answer 22

1. Long term use of a laxative- e.g. osmotic laxative such as laxido or lactulose (adequate fluid in take also recommended)
2. Review of anticholinergic medications

Question 23

What is the therapeutic range for clozapine?

Answer 23

0.35 mg/L to 0.6 mg/L

Question 24

What is the main caution of treatment with clozapine?

Answer 24

Agranulocytosis (having severely low neutrophil levels)
- causing infections and sepsis
Symptoms include
- influenza-like illness
- fever and chills
- sore throat
- mouth sores