Psychiatry – Atypical Antipsychotics & EPS info – Flashcards
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Which of the following is not an atypical antipsychotics: a) clozapine (Clozaril) b) riperidone (Risperdal) c) olanzapine (Zyprexa) d) quetiapine (Seroquel) e) fluphenazine (prolixin) f) lurasidone (Latuda) g) ziprasidone (Geodon) h) All the above are atypcials
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e) fluphenazine (proxilin)
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Which atypical antipsychotics has been shown to be the most effective in treatment resistant cases?
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clozapine (Clozaril)
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What is the risk factor for EPS & TD associated with clozapine (Clozaril)?
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No risk factor! (May actually help decrease s/s of tardive dyskinesia??)
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True or False: clozapine (Clozaril) is a Category B for pregnancy, but can not be used during breast feeding
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True
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Which atypical antipsychotic decreases the risk of suicide?
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clozapine (Clozaril)
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All atypical antipsychotics are approved for the treatment of acute bipolar mania, except?
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clozapine (Clozaril)
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True or False: clozapine (Clozaril) and tegretol are contraindicated to be taken with one another
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True
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Which atypical antipsychotic has the SE of fatal agranulocytosis (therefore, check weekly CBC)
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clozapine (Clozaril)
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Does clozapine (Clozaril) increase or decrease the risk of seizure activity?
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Increase risk
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Which atypical antipsychotic atypical antidepressant has a SE of myocarditis?
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clozapine (Clozaril)
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Which atypical antipsychotic has the most anticholinergic SE?
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clozapine (Clozaril)
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Which atypical antipsychotic can have a SE of hypersalivation?
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clozapine (Clozaril)
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What can decrease the blood levels of clozapine (Clozaril)?
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Smoking/nicotine (NOTE: can decrease the levels of any antipsychotic...but I think clozapine (Clozaril) is the most affected??)
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Which atypical antipsychotic has the greatest hyperprolactinemia SE?
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risperidone (Risperdal)
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Which atypical antipsychotic has the highest chance of EPS?
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risperidone (Risperdal)
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What is the EPS risk factor with risperidone (Risperdal)?
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Highest risk factor out of all other atypical antidepressants
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Which atypical antipsychotic has the highest weight gain SE?
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olanzapine (Zyprexa) (NOTE: 2nd to clozapine (Clozaril))
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Which atypical antipsychotic is very sedating?
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olanzapine (Zyprexa) (ZZZZZZZZZZ)
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Which atypical antipsychotic help with rapid improvement of sleep, and can be used as a sleep aid?
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Quetiapine (Seroquel) (S - Seroquel = S - Sleep)
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Which atypical antipsychotic is has rapid improvement of acute psychosis (woks by day 4)?
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Quetiapine (Seroquel)
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What risk factor for EPS is associated with quetiapine (Seroquel)?
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Low risk EPS
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Which atypical antipsychotic has the following SE associated with it: -weight gain -sedation -orthostatic hypotension
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quetiapine (Seroquel)
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Which atypical antipsychotic can be rapidly titrated over the course of 2 days?
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Ziprasidone (Geodon)
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Which atypical antipsychotic has no weight gain, low rate DM, and low increase in lipids?
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Ziprasidone (Geodon) ("Zip-" = can still zip up your pants) :-)
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Which atypical antipsychotic is no sedation associated with it?
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Ziprasidone (Geodon)
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What is the EPS risk factor for ziprasidone (Geodon)?
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Low rate EPS
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Which atypical antipsychotic has the SE of QT prolongation?
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Ziprazidone (Geodon)
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Which atypical antipsychotic could be also classified as a third generation antipsychotic, and why?
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Aripiprazole (Abilify) -bc is has 2nd generation mechanism and partial 1st generation mechanism
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What are the risk factors for the following scenarios associated with apriprazole (Abilify): 1. Weight gain 2. EPS 3. Cardiovascular 4. Prolactin 5. Akathisias
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1. Low risk weight gain 2. Low risk EPS 3. Low risk CV SE 4. No risk for prolactinemia 5. Can increase akathesias as low doses
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What are the risk factors for the following scenarios associated with Latuda: 1. Weight gain 2. Lipid levels 3. Akathisias
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1. Low risk weight gain 2. Low changes in lipid levels 3. SE of akathisia (NOTE: take Latuda with meal like supper...50% better absorption)
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What increases the absorption of Latuda?
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Take it with meal, like supper...50% better absorption
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High potency or Low potency antipsychotics are more associated with sedation and postural hypotension?
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Low potency
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Seizure activity is most increased by which 2 antipsychotics?
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1. clozapine (Clozaril) 2. chlorothorazine (Thorazine) -- 1st generation
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What is a unifying Black Box warning among 1st generation and 2nd generation antipsychotics?
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Increase mortality in the elderly ...you could prbly also say: -ESP -QT prolongation (at least for a couple of them) -Metabolic syndrome (at least for some of the atypical) ...But all increase death in the elderly
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ESP symptoms with acute dystonia are most common with which of the following? a) males b) elderly c) men under 30 d) women over 30 e) females
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c) men under 30
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ESP symptoms with acute pseudoparkinsonism are most common with which of the following? a) males b) elderly c) men under 50 d) women over 50 e) females f) a and c g) b, d, and e
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g) b, d, and e - are correct Most common in elderly and females
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EPS with Acute Akathisia is most common is which age population?
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More common in middle aged women
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True or False: Among all antipsychotics, the incidence of EPS (Acute Dystonia) is 10%; and the incidence of ESP (pseudoparkinsonsim) is 40%; and the incidence of EPS (Acute akathisia) is 40%
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True
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EPS can be treatment with which medication?
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Benztropine (Cogentin) (Benadryl for dytonias & propranolol for akathisia)
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Which age population is at highest risk for tardive dyskinesia?
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Elderly
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Which atypical antipsychotic may actually help decrease symptoms of tardive dyskinesia?
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Clozapine (Clozaril)
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Among the 2nd generation antipsychotics, which 3 are the most effective?
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Clozapine > Ripserdal > Zyprexa (NOTE: Clozapine is not 1st line though, bc of its SE) --> Clozapine is 3rd line