Wolters Summary - Antipsychotics

Question 1

BBW antipsychotics

Answer 1

elderly patients w/dementia psychosis have increased risk of death

Question 2

FGA summary

Answer 2

more likely to have EPS, TD

ONLY positive

Question 3

SGA summary

Answer 3

less likely to have EPS, TD

negative AND positive

Question 4

antipsychotics S.E.

Answer 4

sedation 
anticholinergics 
orthostatic hypOtension 
E.P.S.
T.D.
QT prolongation 
Seizure 
Agranulocytosis 
Endocrine
weight gain
sexual dysfunciton

Question 5

Tardive dyskinesia

Answer 5

abnormal, involuntary orofacial movements

DON’T give anticholinergics

Question 6

EPS symptoms

Answer 6

parkinsonism
dystonia
akathisia
tardive duskinesia

Question 7

parkinsonism

Answer 7

bradykinesia, rigidity, tremor, akinesia

responses to anticholinergics (diphenhydramine, trihexyphenidyl,bentropine)

Question 8

dystonia

Answer 8

torticollis, larynogospasm

give anticholinergics

Question 9

akathisia

Answer 9

somatic restlessness, inability to stay calm

esp. in legs

responds poorly to anticholinergics – B-blockers instead

Question 10

endocrine S.e. of antipsychotics

Answer 10

prolactin secretion

galactorrhea, menstrual changes

Question 11

NMS

Answer 11

any drug causing dopamine antagonism

hyperthermia, muscle rigidity, encephalopathy, autonomic instability

elevated CK from muscle rigidity

dantrolene given to decrease muscle rigidity (hepatotoxic)

Question 12

TOP FGA (5)

Answer 12

1. Chlorpromazine
2. Fluphenazine (Prolixin)
3. Haloperidol (Haldol)
4. Loxapine
5. Thiothixene

Question 13

IM FGA

Answer 13

1. Chlorpromazine
2. Fluphenazine (Prolixin)
3. Haloperidol (Haldol)

Question 14

LAI FGA

Answer 14

Fluphenazine (Prolixin)

Haloperidol (Haldol)

Question 15

oral FGA

Answer 15

loxapine

Question 16

t or f IV Haldol is common practice

Answer 16

FALSE

although seen, not FDA approved
QTc prolongation S.e.

Question 17

FGA s.e. trends

Answer 17

most of the FGAs cause weight gain

more EPS and prolactin elevation

Question 18

chlorpromazine s.e.

Answer 18

hypercholesterolemia (highest of FGA)
anticholinergics s.e.
othrostatic hypotension

therefore least likely to be used

Question 19

highest cause of anticholinergic s.e. and othrostatic hypotension of FGA

Answer 19

thiothixene

Question 20

Haloperidol
(Fluphenazine)

brand

Answer 20

Haldol

Prolixin

Question 21

SGA main

Answer 21

1. Aripiprazole (abilify)
2. Lurasidone (Latuda)
3. Olanzapine (Zyprexa)
4. Paliperidone (invega)
5. Quetiapine (Seroquel)
6. Risperidone (Risperidal)
7. Ziprasidone (Geodon)
8. Clozapine

Question 22

LAI SGA

Answer 22

Aripiprazole (abilify)
Risperidone (Risperidal)
Paliperidone (invega)

Question 23

IM SGA

Answer 23

Olanzapine (Zyprexa)
Aripiprazole (abilify)
Ziprasidone (Geodon)

Question 24

SGA most likely to cause EPS/Prolactin elevation

Answer 24

paliperidone

risperidone

Question 25

SGA with highest weight gain/hypercholesteremia

Answer 25

clozapine | olanzapine (Zyprexa)

Question 26

antipsychotics and QTc prolongation

Answer 26

IV Haldol | Ziprasidone

Question 27

Aripiprazole

Answer 27

(abilify)

Question 28

Lurasidone

Answer 28

(Latuda)

Question 29

Olanzapine

Answer 29

(Zyprexa)

Question 30

Paliperidone

Answer 30

(invega)

Question 31

Quetiapine

Answer 31

Seroquel

Question 32

Risperidone

Answer 32

(Risperidal)

Question 33

Ziprasidone

Answer 33

(Geodon)

Question 34

aripiprazole MOA

Answer 34

dopamine D1 and 5HT1 agonist 5HT2 antagonist serotonin activity and dopamine activity

Question 35

lurasidone/latuda beneficial efects

Answer 35

theorized to have beneficial cognitive and anxiolytic effects

Question 36

acute agitation

Answer 36

FGA and SGA are of equal efficacy use with benzos

Question 37

CATIE trial

Answer 37

difference in effectiveness between FGA and SGA are not as much as we thought

Question 38

PORT recommendations

Answer 38

for first episode of schizophrenia use any other agent but clozapine

Question 39

pregnancy and antipsych

Answer 39

clozapine/olanzapine can cross into the breast milk

Question 40

geriatric and antipsych

Answer 40

avoid sedation and othrostatic hypotension more prone to QTc