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20 Cards in this Set
- Front
- Back
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21. Where the two other indications for antipsychotics?
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a. Sedation when benzodiazepines are contraindicated or as an adjunct during anesthesia.
b. For movement disorders: Huntington's disease and Tourette's syndrome (to suppress tics and vocalization). |
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22. How are antipsychotics chosen?
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a. Based on their side effect profile, not efficacy.
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23. Where the two conventional high potency antipsychotics?
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1. Fluphenazine
2. haloperidol |
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24. what are the advantages of the high potency conventional antipsychotics?
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a. Less sedating
b. fewer anticholinergic effects c. Les hypotension d. useful as depot injections (e.g., haloperidol decanoate) for noncompliant patients. e. Give IM route for acute psychosis when patient is unwilling or unable to take PO. |
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25. Disadvantages of the high potency conventional antipsychotics?
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a. Grace association with extrapyramidal symptoms (EPS).
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26. Where the two low potency conventional antipsychotics?
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1. Thioridazine
2. chlorpromazine |
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advantages of low potency conventional antipsychotics?
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a. Less likely to cause EPS
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28. disadvantages of low potency conventional antipsychotics?
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a. Greater anticholinergic effects
b. more sedation c. more postural hypotension |
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29. what are 4 atypical antipsychotics?
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1. Risperidone
2. olanzapine 3. quetiapine 4. clozapine |
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30. advantages of the atypical anti-psychotics?
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a. Drug of choice for initial therapy
b. greater effect on negative symptoms c. little or no risk of EPS |
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31. disadvantages of atypical antipsychotics?
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a. Clozapine is reserved for treatment resistant patients because the risk of agranulocytosis.
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32. What did the low potency typical antipsychotics have the greatest risk of causing?
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a. Orthostatic hypotension (alpha blockade)
b. urinary retention, dry mouth, blurry vision c. delirium (anticholinergic effect). 1. change to an atypical antipsychotic if these symptoms are present. |
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33. Side effects of thioridazine? (2)
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a. Prolonged QT, and arrhythmias.
1. Always get an EKG if the case describes chest pain, shorts of breath, or palpitations in a patient taking thioridazine. b. Retinal pigmentation after many years of use. 1. Routine eye exam is need for chronic therapy 2. Thi rhymes with eye. |
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34. Order common reasons for noncompliance in males of with low potency anti-psychotics?
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a. Impotence
b. inhibition of ejaculation (alpha blockade affect) |
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35. with what side effect is clozapine associated?
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a. Agranulocytosis (1%)
b. always check a CBC with differential, both before initiating therapy and weekly after starting therapy. |
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36. A newly diagnosed schizophrenic patient complains of insomnia. What is the most appropriate antipsychotic to initiate therapy? (4)
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a. Olanzapine, quetiapine, ziprasidone, and aripiprazole, our first choice medications when insomnia is a problem.
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37. A schizophrenic patient has been maintained on olanzapine for the past six months. He complains of daytime sedation, and his lost two jobs in the past month because of impaired performance. What is the next step in management?
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a. Prescribe risperidone, a first choice medication for the treatment of schizophrenia. When sedation is a problem.
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38. Note: extrapyramidal symptoms on most common reason for failure to comply with therapy. Be able to identify patient with a medication related movement disorder and know how to minimize the symptoms.
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38. Note: extrapyramidal symptoms on most common reason for failure to comply with therapy. Be able to identify patient with a medication related movement disorder and know how to minimize the symptoms.
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39. Presentation of acute dystonia?
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a. Occurs in the first week of antipsychotic use.
b. Muscle spasms (e.g. torticollis) c. difficulty swallowing d. young men are higher risk. |
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40. Management of acute dystonia, which is secondary to antipsychotics?
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a. Reduce the dose
b. prescribed anti-cholinergic's: 1. benztropine 2. diphenhydramine 3. trihexyphenidyl |
