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25 Cards in this Set
- Front
- Back
delirium |
remove underlying cause antipsychotics first line -haloperidol most studied (po or iv/im) or loxapine -SGA: olanz, risp, quet |
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dementia |
SGA > FGA -risp favourable w alzheimer's -little evidence for quet -haloperidol not routinely recommended pts w NCD with Lewy bodies avoid antipsychotics -cholinesterase inhibitors or mementine BZDs w anxiety -loraz (po, iv) or oxaz (po) -no active metabolites |
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brain injury |
beta-antagonist best evidence -high dose propranolol w agression AED: CBZ or DVP antipsychotics |
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psychosis |
acute psychosis -short-acting parenteral antipsychotic +/- parenteral loraz -AVOID olanz IM + BZD (cardiac & resp complications) po risperidone or olanzapine |
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mania |
SGA -risp, olanz, qet, aripip, zipras IM olanz or FGA + BZD |
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situational agitation/aggression |
FGA + BZD (po or im) SGA |
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CBZ ADRs |
rash cognitive impairment sedation hyponatremia |
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CBZ DI |
induce cyp enzymes: -may increase clearance of oral contraceptives, lovastatin, meperidine, morphine, oxycodone, trazodone |
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DVP ADRs |
nausea tremor sedation rarely edema |
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DVP DI |
inhibits glucuronidation -may decrease clearance of lamotrigine, lorazepam |
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haloperidol ADRs |
sedation parkinsonism akathisia acute dystonia neuroleptic malignant syndrome QTc prolongation |
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haloperidol DI |
-additive CNS depression -antagonism of dopamine agonists -avoid other QT prolonging drugs |
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aripiprazole ADRs |
akathisia dizziness orthostatic hypotension headache GI tremor sedation |
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aripiprazole DI |
-CBZ (induce CYP2D6 or 3A4) decrease aripip levels -ketoconazole, quinidine, fluoxetine, paroxetine (inhibit CYP 2D6 or 3A4) increase levels |
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olanzapine ADRs |
anticholinergic effects akathisia dizziness neuroleptic malignant syndrome |
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olanzapine DI |
-additive sedation w CNS depressants -antagonism of dopamine agonists -potentiate antihypertensive drug effects IM olanzapine should not be administered w parenteral BZDs due to cardiac & respiratory problems including death |
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quetiapine ADRs |
sedation dizziness neuroleptic malignant syndrome |
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risperidone ADRs |
akathisia dizziness nerolepti malignant syndrome |
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risperidone DI |
-additive sedation w CNS depressants -antagonism of dopamine agonists -may potentiate antihypertensive drug effects |
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ziprasidone ADRs |
-insomnia -EPS -consider ECG at baseline and periodically to monitor effect on QTc interval |
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ziprasidone DI |
-CBZ decreases ziprasidone levels -do not use w other QT prolonging drugs |
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clonazepam ADRs |
sedation dizziness cognitive impairment rarely respiratory depression |
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clonazepam DI |
-additive sedation and possibly cardiorespiratory depression w other CNS depressants |
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propranolol ADRs |
bradycardia hypotension heart block sedation |
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propranolol DI |
-additive hypotension w other antihypertensives -additive sedation w other CNS depressants |