Therapeutics Exam 2 Antipsychotics

Front 1

What are the 4 categories of symptoms in schizophrenia?

Back 1

positive (hallucinations, delusion)
negative (reduction in drive and interest)
affective (depression, anxiety)
cognitive (problems with learning or memory)

Front 2

What are the atypical antipsychotics?

Back 2

clozapine
olanzapine
quetiapine
asenapine

iloperidone
paliperidone
risperidone

aripiprazole

Front 3

Atypical antipsychotics have increased efficacy for what symptoms?

Back 3

negative symptoms

Front 4

Blocking what receptor is effective at reducing positive psych symptoms?

Back 4

D2

Front 5

Blocking what receptor is effective at reducing negative psych symptoms?

Back 5

5HT2a

Front 6

Agonism of what receptor improves cognition and has antidepressant and anxiolytic effects?

Back 6

5HT1a

Front 7

Blocking what receptor improves symptoms of depression?

Back 7

5HT2d

Front 8

Blocking what receptor decreases positive psych symptoms but causes weight gain?

Back 8

5HT2c

Front 9

What is the difference between antipsychotic drugs and antidepressant drugs?

Back 9

antipsych drugs are not interchangeable

Front 10

What antipsych is a potent histamine blocker making it useful in schizophrenics with trouble sleeping?

Back 10

olanzapine

Front 11

What drug mildly stimulates dopamine?

Back 11

aripiprazole

Front 12

What could happen if you switch from a pure dopamine blocking medication to aripiprazole?

Back 12

could induce a psychotic event

Front 13

Aripiprazole is a good choice in what type of patient?

Back 13

drug naive patient

Front 14

What antipsych med is SL or buccal which causes compliance problems?

Back 14

asenapine

Front 15

What are the EPS side effects seen in antipsych drugs?

Back 15

akathisia (inner restlessness)
pseudoparkinson syndrome
muscle stiffness (neck and jaw)
dystonia

Front 16

EPS symptoms increase with the degree of blocking what neurotransmitter?

Back 16

dopamine

Front 17

What antipsych has lower chances of EPS symptoms?

Back 17

quetiapine
(may be good for parkinson pt with psych issues)

Front 18

What antipsych drug causes the longest prolongation of QTc interval?

Back 18

ziprasidone

Front 19

What antipsych drug has the LOWEST chance of significant weight gain?

Back 19

ziprasidone

Front 20

What antipsych drug has the HIGHEST chance of significant weight gain?

Back 20

olanzapine

Front 21

Blocking what neurotransmitter causes weight gain?

Back 21

serotonin

Front 22

What medication added to an antipsychotic will reduce the chances of significant weight gain?

Back 22

metformin

Front 23

What side effect of antipsychotics increases with age, long duration of treatment, and high dose?

Back 23

tardive dyskinesia

Front 24

What antidepressant mildly enhances dopamine and could lead to psychosis?

Back 24

bupropion

Front 25

Dopamine blockers used with what antipsychotic drug has a high risk of developing EPS symptoms?

Back 25

risperidone

Front 26

Orthostasis may occur when valium, alcohol, or any alpha 1 blockers, are taken with what antipsychotic drugs?

Back 26

olanzapine
paliperidone
iloperidone
asenapine

Front 27

What antipsych causes increased sedation with drugs with alternate mechanisms for inducing sedation?

Back 27

quetiapine

Front 28

Lovastatin taken with what antipsych causes prolonged QTc interval?

Back 28

quetiapine

Front 29

What antipsych moderately inhibits NE and 5HT reuptake, and could be toxic if given with TCAs or SSRIs?

Back 29

ziprasidone

Front 30

What antipsychs may have similar dopaminergic interactions to risperidone?

Back 30

paliperidone
iloperidone
asenapine

Front 31

Which antipsych blocks dopamine the least, making it safer to give to an ADHD patient who also takes a stimulant?

Back 31

quetiapine

Front 32

What type of drugs increase dopamine, counteracting the effects of antipsychotic drugs?

Back 32

stimulants

Front 33

What enzymes metabolize atypical antipsychotics, causing frequent drug interactions?

Back 33

CYP2D6
CYP3A4
CYP1A2 (olanzapine)

Front 34

Cigarette smoking causes a 40% decrease in levels of what antipsych?

Back 34

olanzapine
(CYP1A2)

Front 35

Giving warfarin with what antipsych may dramatically increase the INR?

Back 35

quetiapine

Front 36

What are 3 reasons why a high dose of antipsychotics is often used?

Back 36

to attain appropriate serum levels
biological/refractory disease
risk is low

Front 37

An antipsychotic drug reaches 75% of its efficacy when?

Back 37

3 wks
(no need to wait more than this to switch to new agent)