Sc

Front 1

low potency typical agents

Back 1

-chlorpromazine
-thioridazine

Front 2

typical agents MOA

Back 2

dopamine antagonists (greater affinity at D-2 yhan D-1) that have effects on all 4 dopaminergic pathways

Front 3

decreased dopamine release or dopaminergic inactivation occurs after how many days?

Back 3

21d

Front 4

low poteny or high potency agents have less specificity for dopamine receptors

Back 4

low potency

Front 5

low potency agents are associated with:
-EPS rxns
-sedation
-postural hypotension
-seizure threshold
-ECG
-anticholinergic adverse effects

Back 5

-fewer EPS rxns than high potency
-more sedation
-more postural hypotension
-greater effect on SZR threshold and ECG
-more frequent anticholinergic effects

Front 6

receptor blockade for typical AP

Back 6

-histamine
-muscarinic
-a1 adrenergic
-dopamine D2

Front 7

adverse effects of dopamine D2 blockade

Back 7

-EPS
-prolactin elevation

Front 8

dystonia treatment

Back 8

-benztropine 1-2mg IM
-diphenhydramine 25-50mg IM

-above may be given as scheduled oral doses for at least 1 month after dystonia resolved

Front 9

dystonia prophylaxis

Back 9

benztropine may be given when high potency APs initiated

Front 10

akathisia treatment

Back 10

-propanolol
-diazepam

Front 11

pseudoparkinsonism treatment

Back 11

-benztropine 1-2mg bid
-trihexyphenidyl 2-5mg tid
-diphenhydramine 25-50mg tid
-amantadine 100mg bid

-give for 6w-3m after sxs resolve

Front 12

tardive dyskinesia treatment

Back 12

-decrease dose of typical AP
-switch to atypical AP
-vitamin E 1200-1600IU/d
-BZDs
-botulinum toxin
-clozapine

Front 13

APs that have highest potential to cause SZRS

Back 13

-clozapine
-chlorpromazine

Front 14

neuroleptic malignant syndrome treatment

Back 14

-d/c AP
-dopamine agonist - bromocriptine
-skeletal muscle relaxants - dantrolene

Front 15

APs most likelt to cause ECG changes and prolong QTC interval

Back 15

-thioridazine
-ziprasidone

Front 16

agents most likely to cause increase in prolactin

Back 16

-typical APs
-risperidone

Front 17

fluphenazine oral to deconoate

Back 17

10mg/day oral = 12.5mg IM q2wk

Front 18

haloperidol oral to deconoate

Back 18

10mg/day oral = 100-150mg IM q4wk
(initial injection shouldn't exceed 100mg)

Front 19

atypical antipsychotics (6)

Back 19

-clozapine
-risperidone
-olanzapine
-quitiapine
-ziprasidone
-aripiprazole

Front 20

list 7 potential advantages of atypical agents over conventional agents

Back 20

1)improved response to neg sxs
2)mood stabilizing effects
3)pos response in pts refractory to traditional agents
4)reduced risk of EPS
5)reduced risk of TD
6)improved compliance
7)minimal effect on serum PL

Front 21

clozapine FDA indications

Back 21

1)schizophrenia, tx resistant
2)suicidal behavior
(reserved for pts refractory to at least 2 adequate trials of other AP drugs)

Front 22

clozapine adverse effects (6)

Back 22

-hypersalivation
-tachycardia
-constipation (antichol effec)
-weight gain
-glucose dysregulation
-increased lipids

Front 23

list 4 black box warnings for clozapine

Back 23

1)agranulocytosis and granulocytopenia
2)myocarditis
3)seizures
4)orthostasis

Front 24

clozapine therapy guidelines based on WBC and granulocyte count
WBC<3500, h/o myeloproliferative d/o, previous clozapine-induced agranulocytosis or granulocytopenia

Back 24

do not initiate treatment

Front 25

WBC 3000-3500
granulocyte count >1500

Back 25

-interrupt therapy
-perform twice weekly WBC and differential counts

Front 26

WBC <3000
granulocyte count <1500

Back 26

-interrupt therapy
-may resume therapy if no s/x of infection develop, WBC >3000 and granulocyte count >1500
-twice weekly blood counts until WBC>3500

Front 27

WBC <2000
granulocyte <1000

Back 27

-consider bone marrow aspiration
-possible protective isolation
-antibiotics if infection develops
-DO NOT RECHALLENGE

Front 28

clozapine monitoring

Back 28

CBC must be drawn weekly x6months; then biweekly x6months; then q4wks thereafter

Front 29

clozapine initial dose

Back 29

12.5-25mg qhs

Front 30

increasing clozapine dose

Back 30

25mg daily until a dosage of 300mg daily is achieved (subsequent dose changes should be made once weekly in small increments)

Front 31

maximum clozapine dose

Back 31

900mg/daily

Front 32

how to restart patients who have had a brief interval off clozapine (2 days or more)

Back 32

treatment needs to be reinitiated at 25mg/day

Front 33

risperidone FDA indications

Back 33

1)schizophrenia
2)bipolar mania (acute)

Front 34

risperidone adverse effects (2)

Back 34

1)EPS (higher doses)
2)prolactin elevation (higher doses)

Front 35

risperidone doses exceeding what are not recommended and associated w/ more EPS and adverse effects

Back 35

6mg

Front 36

olanzapine FDA indications

Back 36

1)schizophrenia
2)agitation associatged w/ schizophrenia
3)bipolar mania (acute)
4)bipolar d/o maintenance

Front 37

olanzapine adverse effects (3)

Back 37

1)weight gain
2)glucose dysregulation
3)increased lipids

Front 38

quetiapine FDA indications

Back 38

1)schizophrenia
2)bipolar mania (acute)

Front 39

quetiapine adverse effects (2)

Back 39

1)drowsiness
2)lens examination to detect cataract formation recommended at initiation and at 6-month intervals

Front 40

ziprasidone FDA indications

Back 40

1)schizophrenia
2)agitation associated w/ schizophrenia
3)bipolar mania

Front 41

ziprasidone adverse effects (1)

Back 41

1)QTC prolongation

Front 42

aripiprazole FDA indications

Back 42

1)schizophrenia
2)bipolar mania

Front 43

aripiprazole MOA

Back 43

-partial agonist at D2 and 5HT1A receptors
-5HT2A antagonist
-moderate alpha-1 adrenergic blockdade
-moderate antihistaminergic effect

Front 44

List 5 monitoring and assessment parameters for atypical APs
1)wt and ht
2)waist circumference
3)fasting glucose
4)fasting lipid panel
5)blood pressure

Back 44

1)baseline, 4wks, 8wks, 12wks, thenquarterly
2)baseline, then annually
3-5)baseline, 12wks,then annually