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schizoprenia Flashcards

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1
Q

what are the 3 main positive symptoms?

A

delusions
hallucinations
disorganized speech and behavior

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2
Q

what are the 5 negative symptoms?

A

grooming
alogia (poverty of speech)
anhedonia (decreased interest)
affect-flat
cognitive

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3
Q

how long do symptoms need to be occurring for diagnosis?

A

1 month

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4
Q

what are the symptoms that are required for a diagnosis?

A

delusions, hallucination, disorganized speech. disorganized or catatonic behavior, or negative symptoms

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5
Q

how many symptoms are needed for diagnosis, and which ones are required?

A

2 or more and at least one must be delusion, hallucination, or disorganized speech

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6
Q

how long after remission should you treat?

A

12 months

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7
Q

how long until stabilization on treatment?

A

6-12 months

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8
Q

how long until changes are seen?

A

2 weeks

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9
Q

what is TRS?

A

failed trials of at least 2 antipsychotics at max dose

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10
Q

which antipsychotic can take 6 months to work?

A

clozapine

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11
Q

which generation has EPS?

A

1st

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12
Q

MOA and class of clozapine

A

2nd gen
mixed D2/5HT2a antagonist

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13
Q

Which two 1st gens have high H1,a1, and M1 antagonism but low D2 antagonism?

A

chlorpromazine
thioridazine
(C-Thior)

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14
Q

Which two 1st gens have moderate H1,a1, and M1 antagonism and moderate D2 antagonism?

A

loxapine
perphenazine
(Loxa-P)

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15
Q

Which 4 1st gens have low H1,a1, and M1 antagonism but high D2 antagonism?

A

trifluoperazine
thiothixene
fluphenazine
haloperidol
(Tri-Thio-Flu-Hal)

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16
Q

-zine is common to?

A

1st gens

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17
Q

what is the exception to -zine in first gens

A

loxapine
haloperidol
thiothixene

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18
Q

which generation has metabolic effects?

A

2nd

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19
Q

which three 2nd gens high H1,a1, and M1 antagonism but low D2 antagonism?

A

quetiapine
clozapine
olanzapine
(CoQ)

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20
Q

Which three 2nd gens have moderate H1,a1, and M1 antagonism and moderate D2 antagonism?

A

iloperidone
paliperidone
risperidone
(RIP)

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21
Q

Which three 2nd gens have low H1,a1, and M1 antagonism and high D2 antagonism?

A

brexpiprazole
cariprazine
aripiprazole
(CAB)

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22
Q

Which three 2nd gens have lowest H1,a1, and M1 antagonism and highest D2 antagonism?

A

asenapine
lurasidone
ziprasidone
(ALZ)

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23
Q

what is -pine, -done, and -zole common to?

A

2nd gen

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24
Q

what is the exception to -pine, -done, and -zole?

A

cariprazine

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25
which antipsychotics are 1A2 metabolized?
clozapine olanzapine astenapine (CoA)
26
which antipsychotics are 2D6 metabolized?
risperidone fluphenazine clorpromazine (FCR)
27
which antipsychotics are 3A4 metabolized?
quetiapine ziprasidone lurasidone (LQZ)
28
which antipsychotics are BOTH 2D6 and 3A4 metabolized?
iloperidone aripiprazole brexpiprazole cariprazine haloperidol (HABIC)
29
which is renally eliminated?
(RP)paliperidone and risperidone
30
which have a DDI with smoking?
clozapine and olanzapine
31
which have DDI with rifampin, ritaonavir, and phenytoin?
quetiapine and ziprasidone
32
which has the most DDI?
carbamazepine
33
which 2nd gens have orthostasis, anticholinergic, metabolic rate syndrome, and Low EPS?
(CoQ) clozapine, olanzapine, quetiapine
34
which is used for agitation, delirium, anxiety, and depression?
quetiapine
35
which one is used for TRS, suicidality and in those with PD, alzheimers?
clozapine
36
which one has black box warning of agranulocytosis, seizure, myocarditis?
clozapine
37
(T/F) all antipsychotics have a risk of mortality in elderly with dementia related psychosis
T
38
(T/F) all antipsychotics have a risk of suicidal thoughts?
T, but more common in 2nd gen
39
which antipsychotics have orthostasis and hyperprolactinema?
(RIP) risperidone iloperidone palperidone
40
which antipsychotics have partial D2 agonism, long t1/2, akathisia, and lowest metabolic side effects?
(CAB) aripiprazole, brexpiprazole, cariprazine
41
which antidepressant is used in tourettes and autism?
aripiprazole
42
which 2 can be adjunct in MDD?
aripiprazole and brexipiprazole
43
which is D2 antagonizing?
cariprazine
44
which antipsychotics are weight neutral and have more EPS risk?
asenapine, lurasidone, zirasidone (ALZ)
45
with antipsychotic has ulcers, bad taste as a side effect?
asenapine
46
which antipsychotic needs to be BID with over 500 calories?
ziprasidone
47
which antipsychotic has highest QTc risk?
ziprasidone
48
which antipsychotic needs to be with over 350 calories?
lurasidone
49
which antipsychotic has post injection delirium sedation symptom?
olanzapine LAI
50
what is pimavanserin's indication and MOA?
parkinsons psychosis 5HT2a reverse agonist
51
what is pimozide indication and MOA?
tourettes D2 antagonist
52
the mesolimbic is responsible for?
+ symptoms
53
the mesocortical is responsible for?
neg. symptoms
54
D2 antagonism is responsible for?
EPS and prolactin stimulation
55
Akathisia is..,
internal restlessness
56
akathisia symptoms include...
leg shuffling and cant sit still, pacing
57
akathisia treatment is...
propanolol benzos
58
dystonia is...
involuntary contractions
59
dystonia symptoms are...
eyes rolling, tongue leaden, cant swallow, neck twisting
60
dystonia treatment is...
benadryl, benztropine, trihexyphenidyl
61
parkinsonism is...
brady/hypokinesia, tremor, rigid
62
parkinsonism symptoms are...
masked face, decreased arm swing, shuffling walk, difficulty moving
63
parkinsonism treatment is...
benadryl, benztropine, trihexyphenidyl
64
what is tardive dyskinesia?
abnormal, involuntary movement
65
what are tardive dyskinesia symptoms?
blinking, lip smacking, jaw movement, grimacing, rocking/twisting, irregular limb movement
66
what is tardive dyskinesia treatment?
VMAT2 inhibitor
67
MOA of valbenazine
VMAT2 inhibitor, less Dopa release to synapse
68
what does Dopa block in the tuberoinfundibular tract cause?
hyperprolactinemia
69
which antipsychotic causes hyperprolactinemia?
risperidone
70
which antipsychotics have CV risk?
haloperidol ziprasidone thioridazine (ZHT)
71
what is the treatment for NMS?
stop all dopa blockers
72
which antipsychotic is used in pregnancy?
haloperidol
73
which antipsychotic is used in breastfeeding?
(AQ)aripiprazole and quetiapine
74
which antipsychotics are AVOIDED in elderly?
(HZ)ziprasidone and haloperidol

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