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22 Cards in this Set
- Front
- Back
do genetics play a role in depression and schizophrenia? what is thought to cause psychotic symptoms? |
yes excessive dopamine in certain areas of the brain |
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what are the positive symptoms? what do these symptoms usually lead to? |
these symptoms are added on hallucinations delusions thought/speech disorder movement disorder (highschool hall, next to eachother, speech, crowd with wierd movements) hospitalization |
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what are the negative symptoms also known as? what are these symptoms? |
taken away of affective social withdrawal diminished emotional expression depressive symptoms poor self care sleep and appetite disturbances (dads social, but emotional, which is why he is poor and he cant sleep, and he gets depressed |
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what are the cognitive symptoms? |
defiences in attention processing verbal/visual memory working memory problem solving PAP is a verbal worker |
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what other disease states may result from schizophrenia? how does a schizos lifespan compare to a normal person? what class of meds treats schizophrenia? what is unique about these medications? |
copd, diabetes, obesity 25 years shorter antipsychotics all have very different side effect profiles |
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other than side effects, and the risk benefit ratio, what else should be considered in selecting an antipsychotic? generally, what type of symptoms do antipsychotics treat? |
cost/insurance/generics ideally positive symptoms |
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what are the biggest take home points from the CATIE trial? |
FGA are just as efficacious as the SGAs, but SGAs have less EPS and relapse also SGAs are better for negative and cognitive symptoms |
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what receptors do the SGAs inhibit? what are major side effect differences of the FGA and the SGA? |
D2 and 5-HT 2A FGA has more EPS and motor side effects SGA has more weight gain, glucose/lipid abnormalities and metabolic syndrome |
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what are the two newest antipsychotics? is there anything unique cariprazine? |
brexpiprazole and cariprazine D3 partial agonist |
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what are the most important side effects of risperidone and paliperidone? most important side effects of quetiapine and ziprasidone? what circumstances will increase risk of tor sades too? |
hyperprolactinemia galactorrhea gynecomastia qtc prolongnation congenital qt syndrome, arrythmia, hypokelmia, hypomagnesmia, eletrolyte disturbances |
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what SGA long acting has a REMS? why did it get a REMS? why are the long acting SGAs usually not reccomended? |
zyprexa relprevv- postinjection delerium syndrome none are generic, cost a lot, frequent visits to office |
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what is the term for FGA long acting agents? what are the cons of using these? |
decanotes potent-alot of eps and other side effects, but it is cheaper |
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what receptors are the dirty receptors? what drug has a bbw for qtc prolongnation? |
histamine, cholinergic, alpha , antipsychotics/andidepressants block these which causes symptoms thioridazine |
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what are the signs and symptoms of acute dystonia? time to onset? risk factors? treatment? |
muscle spasm or abnormal postioning of head/neck/limbs 24-96hours high potency FGA, young males antihistamine like benadryll (IM) |
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what are the signs and symptoms of akathisia? time to onset? risk factors? treatment? |
motor or restlessness 1 month high doses, younger people BB, anticholingergics, benzos |
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what are the signs and symptoms of pseudoparkinsonism? time to onset? risk factors? treatment? |
maskilke facial expression, absences of arm swing when walking 1-2 weeks older females, high doses, depressive symptoms anticholinergics, dopamine agonist |
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what are the signs and symptoms of tardive dyskinesia? time to onset? risk factors? treatment? |
abnormal movements and slow or irregular movements 3 months older age, long use of antipsychotics EPS, substance abuse, mood disorders |
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what are the signs and symptoms of neurleptic malignant syndrome? what is the mean percentage of schizophrenics that are complient? how many more times likely is a nonadherent patient likely to relapse? |
muscle rigidity, fever autonomic instability (changes in blood pressure), delirium 50% 4x |
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why is it difficult to identify non adherence in schizophrenics? what are risk factors for nonadherenence? |
no connection between nonadherence and symptoms exacerbation no immediate consequences of missing a dose delusions, substance abuse, negative symptoms |
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what antipsychotics are approved in children/adolescents? what side effects are more sensitive in this population? |
aripiprazole, risperidone, quetiapine, paliperidone, olanzapine (RAP OQ) EPS, weight gain, sedation, hyperprolactemia |
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what should every schizophrenic patient be evaluated for? define treatment resistant |
substance abuse persistant postive sypmptoms despite treatmen with at least two different antipsychotics at adequate doses and duration, also must have moderate to severe illness for at least 5 years |
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what drug do you give for suicide or treatment resistant patients? what are the main side effects of these drugs? |
clozapine agranulocytosis (low granulocytes), cv events, seizure, hyperlactemia, metabolic syndrome |