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34 Cards in this Set

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Major route of elimination for Lithium
Kidneys
Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop
Lithium toxicity
Drug increases the renal clearance hence decreases levels of lithium
Theophylline
Lithium is associated with this congenital defect
Cardiac anomalies and is contraindicated in pregnancy or lactation
DOC for bipolar affective disorder
Lithium
Concern using lithium
Low therapeutic index
SE of lithium
Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus
Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor
Older antipsychotic agents, D2 receptors
MOA of neuroleptics
Dopamine blockade
Side effects occuring in antipsychotics that block dopamine
Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain
Antipsychotics that reduce positive symptoms only
Older antipsychotics
Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation
Olanzapine, aripiprazole, and sertindole
Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia
Risperidone
Atypical antipsychotic causing high prolactin levels
Risperidone
Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes
Olanzapine
Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker
Haloperidol
Drug used in neuroleptic malignant syndrome
Dantrolene
Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)
Muscarinic blockers
Antipsychotic having the strongest autonomic effects
Thioridazine
Antipsychotic having the weakest autonomic effects
Haloperidol
Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias
Thioridazine
Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause fatal agranulocytosis
Clozapine
Anti-psychotic not shown to cause tardive dyskinesia
Clozapine
Anti-psychotics available in depot preparation
Fluphenazine and haloperidol
Reduced seizure threshold
Low-potency typical antipsychotics and clozapine
Orthostatic hypotension and QT prolongation
Low potency and risperidone
Increased risk of developing cataracts
Quetiapine
antipsychotic least likely to cause acute dysonic reactions
olanzapin (minimal D2 receptor blocking)
clozapine has low affinity for what receptors?
D2
how do thiazides affect lithium dosage?
dosage needs to be decreased because clearance is decreased
acute treatment of acute dystonic reactions
injection of benztropine
what is the safest drug to use to tx bipolar during pregnancy?
olanzapine
what antipsychotic causes agranulocytosis?
Clozapine
what drug has high affinity for 5-HT2 receptors, doesn't cause extrapyramidal dysfunction or hematotoxicity and increases risk of QT prolongation?
ziprasidone