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