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18 Cards in this Set
- Front
- Back
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For what question is risperidone the answer?
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Risperidone is a treatment for chronic schizophrenia.
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How does risperidone work?
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The precise mechanism of risperidone is unknown. Risperidone has an affinity for antagonizing both serotonin and dopamine receptors.
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What are the most common adverse effects of risperidone?
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Risperidone can cause weakness (asthenia), sedation, difficulty concentrating, and hypotension. It can cause elevated prolactin levels, weight grain, and sexual dysfunction. The incidence of tardive dyskinesia is greater with risperidone than with the other second-generation antipsychotic medications.
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When are Olanzapine, Ziprasidone, Quetiapine, Aripiprazole, Clozapine, and Risperidone the answer?
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These medications are all second-generation or "atypical" antipsychotic medications. Clozapine is the most efficacious but has the highest incidence of adverse effects, such as agranulocytosis.
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How does Olanzapine, Ziprasidone, Quetiapine, Aripiprazole, Clozapine, and Risperidone work?
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The precise mechanism of these medications is unknown. They all bind to serotonin and dopamine receptors. Most also bind to central alpha receptors as well as the histamine receptor.
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What are the most common adverse effects of Olanzapine, Ziprasidone, Quetiapine, Aripiprazole, Clozapine, and Risperidone?
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They all can cause hypotension and somnolence. Most cause weight gain.
Zirasidone can prolong the QT interval the most. Risperidone has the highest incidence of tardive dyskinesia and prolactin elevation. Clozapine is the only one that suppresses the bone marrow. |
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List five SSRIs.
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Fluoxetine
Paroxetine Sertraline Fluvoxamine Escitalopram |
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What are SSRIs?
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Selective serotonin reuptake inhibitors are the most commonly used antidepressant medications.
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How do SSRIs work?
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SSRIs work by blocking the reuptake of 5HT presynaptically. This leaves more 5HT to stimulate the receptor.
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When are SSIRs the answer?
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SSRIs are the best initial therapy for severe depression. In addition, SSRIs treat OCD, eating disorders, anxiety, ADD, and dysmenorrhea.
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What are the most common adverse effects of SSRIs?
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There is a possible increased risk of suicide in the first few months after starting these medications. SSRIs can also cause sexual dysfunction such as impaired ejaculation.
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A 32 yo woman comes to the ED because of the acute onset of facial grimacing, torticollis, oculogyric crisis, and abnormal contractions of the spinal muscles. She has just been started on antipsychotic medication fluphenazine as well as metroclopromide for nausea.
What is the diagnosis? |
This patient has an acute dystonic reaction from both the antipsychotic medications as well as the metocloprimide. Her symptoms consist of an acute oculogyric crisis as well as torticollis.
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A 32 yo woman comes to the ED because of the acute onset of facial grimacing, torticollis, oculogyric crisis, and abnormal contractions of the spinal muscles. She has just been started on antipsychotic medication fluphenazine as well as metroclopromide for nausea.
How did this happen? |
The precise mechanism of an acute dystonic reaction is unclear. It occurs because of the antidopaminergic effect of antipsychotic medications as well as metochlopromide.
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A 32 yo woman comes to the ED because of the acute onset of facial grimacing, torticollis, oculogyric crisis, and abnormal contractions of the spinal muscles. She has just been started on antipsychotic medication fluphenazine as well as metroclopromide for nausea.
What is the best initial therapy? |
Acute dystonic reactions are treated very effectively and rapidly with diphenhydramine and benztropine.
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How does lithium work?
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Lithium is an alkali metal has no effect in a normal person but can treat symptoms of certain mood disorders. The proposed mechanism may be through suppression of inosital triphosphate, although lithium's precise therapeutic mechanism is unknown.
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What are the most common adverse effects of lithium?
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Lithium's adverse effects include the following:
1) Tremor, ataxia, and seizures 2) Nephrogenic diabetes insipidus through inhibition of the ADH receptor 3) Hypothyroidism by inhibiting thyroglobulin iodination and coupling. 4) Teratogenesis, particularly Ebstein's anomaly |
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When is lithium the answer?
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Lithium is indicated for bipolar disorder and acute mania. It is prophylactic against migraine and cluster headaches.
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Your patient has recently been started on the antipsychotic medication ziprasidone after being on risperidone at high dose. He becomes febrile to 105F and is somewhat catatonic with muscle rigidity, confusion, and an elevated CPK level.
What is the best initial therapy of this patient? |
Neuroleptic malignant syndrome is managed with dopamine agonists, such as bromocriptine.
Dantrolene is used as well as can help relieve muscular rigidity. |
