front 1 Definition of dystonias | back 1 Prolonged contraction of muscles during drug initiation, including painful muscle spasms |
front 2 Definition of akathisia | back 2 restlessness with anxiety and inability to remain still |
front 3 Definition of parkinsonism | back 3 looks similar to parkinson disease, with tremors, abnormal gait and bradykinesia |
front 4 Definition of tardive dyskinesias | back 4 abnormal facial movements, primarily in the tongue or mouth |
front 5 Definition of dyskinesias | back 5 abnormal movements, more common with dopamine replacement for parkinson disease |
front 6 What is schizophrenia | back 6 chronic, severe and disabling thought disorder |
front 7 Common symptoms of schizophrenia | back 7 hallucinations, delusions, disorganized thinking/behavior |
front 8 Definition of hallucinations | back 8 sensing something that is not present, such as imaginary voices |
front 9 Definition of delusions | back 9 a belief about something real that is not true, such as imagining that your family (which is real) wishes to hurt you (delusion) |
front 10 Definition of disorganized thinking/behavior | back 10 inability to focus attention and communicate organized thoughts |
front 11 How is schizophrenia diagnosed | back 11 based on behavior which includes both negative and positive signs and symptoms |
front 12 Schizophrenia pathophysiology | back 12 includes altered brain structure and chemistry, primarily involving dopamine, serotonin and glutamate |
front 13 Negative signs and symptoms | back 13 loss of interest in everyday activities, lack of emotion (apathy), inability to plan or carry out activities, poor hygiene, social withdrawal, loss of motivation (avolition), lack of speech (alogia) |
front 14 Positive signs and symptoms | back 14 hallucinations (auditory, visual, somatic), delusions, disorganized thinking/behavior, difficulty paying attention |
front 15 Medications that can cause psychotic symptoms | back 15 anticholinergics, dextromethorphan, dopamine agonists, interferons, stimulants, systemic steroids, illicit/recreational substances, cannabis |
front 16 Antipsychotics primarily block | back 16 dopamine receptors (newer antipsychotics also block serotonin and other receptors) |
front 17 Decreasing dopamine activity helps control psychosis but | back 17 negatively affects dopamine pathways involved in focus, attention and movement |
front 18 What class of medications are used first-line due to a lower incidence of EPS | back 18 second generation antipsychotics (SGAs) |
front 19 Benefits of long-acting injections | back 19 eliminate the need for daily oral tablets or capsules. They are given IM |
front 20 Benefits of orally disintegrating tablets (ODTs) | back 20 useful with dysphagia (difficulty swallowing) and prevents cheeking |
front 21 Benefits of oral solutions/suspension | back 21 useful with children and people with a feeding tube |
front 22 Benefits of acute IM injections | back 22 provide "stat" relief to calm down an agitated, psychotic patient |
front 23 IM antipsychotic are often mixed with | back 23 other drugs in "cocktail" such as BZDs (anxiolytic/sedative effects) and anticholinergics (to reduce dystonia) |
front 24 Why should olanzapine and BZDs not be given together | back 24 due to risk of excessive sedation and breathing difficulty |
front 25 How do first generation antipsychotics work | back 25 mainly by blocking dopamine (D2) receptors with minimal serotonin receptor blockade |
front 26 Low potency FGAs | back 26 chlorpromazine and thioridazine |
front 27 Mild potency FGAs | back 27 loxapine and perphenazine |
front 28 High potency FGAs | back 28 haloperidol, fluphenazine, thiothixene, trifluoperazine |
front 29 Brand name of haloperidol | back 29 Haldol |
front 30 Treatment/prophylaxis for dystonia | back 30 anticholinergics (benztropine), diphenhydramine |
front 31 Treatment for akathisia | back 31 BZDs and propranolol |
front 32 Treatment for tardive dyskinesia | back 32 stop the drug and replace with an SGA with low risk of EPS |
front 33 MOA of SGAs | back 33 block dopamine (D2) and serotonin (5-HT2A) receptors |
front 34 Which SGAs are D2 and 5-HT1A partial agonist | back 34 aripiprazole, brexpiprazole and cariprazine |
front 35 Abilify Maintena is a | back 35 IM suspension given monthly |
front 36 Brand name of clozapine | back 36 Clozaril |
front 37 When can clozapine be prescribed | back 37 only if failed to respond to 2 standard AP treatments or had significant ADRs |
front 38 Brand name for lurasidone | back 38 Latuda |
front 39 Brand name for olanzapine | back 39 Zyprexa |
front 40 Brand name for paliperidone | back 40 Invega |
front 41 Brand name for risperidone | back 41 Risperdal |
front 42 Brand name for ziprasidone | back 42 Geodon |
front 43 Paliperidone is the active metabolite of | back 43 risperidone |
front 44 Brand name for cariprazine | back 44 Vraylar |
front 45 Brand name for asenapine | back 45 Saphris |
front 46 Invega Sustenna is a | back 46 IM injection given monthly |
front 47 Invega Trinza is a | back 47 IM injections given every 3 months |
front 48 Invega Hafyera is a | back 48 IM injection, given every 6 months |
front 49 Which risperidone is an IM injection given every 2 weeks | back 49 Risperdal Consta |
front 50 SGA metabolic side effects | back 50 weight gain, increased cholesterol, increased triglycerides, increased blood glucose |
front 51 Clozapine boxed warnings | back 51 agranulocytosis, seizures, myocarditis |
front 52 Antipsychotics used for acute psychosis (STAT) | back 52 haloperidol (sometimes in combination with lorazepam and diphenhydramine), ziprasidone and olanzapine |
front 53 What medication is used for psychosis in parkinson disease | back 53 Nuplazid |
front 54 Generic name of Nuplazid | back 54 pimavanserin |
front 55 Asenapine sublingual can cause | back 55 tongue numbness |
front 56 MOA of Nuplazid | back 56 inverse agonist and antagonist at 5-HT2A receptors |
front 57 First medication approved for tardive dyskinesia | back 57 Valbenazine |
front 58 Brand name of valbenazine | back 58 Ingrezza |
front 59 MOA of Ingrezza | back 59 reversibly inhibits vesicular monoamine transporter 2 (VMAT2) which is a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release |
front 60 Brand name and indication for deutetrabenazine | back 60 Austedo for tardive dyskinesia |
front 61 What can occur with all antipsychotics | back 61 Neuroleptic malignant syndrome (NMS) - rare but highly lethal |
front 62 Signs of NMS | back 62 hyperthermia, extrema muscle rigidity, mental status changes, tachycardia, tachypnea and blood pressure changes |
front 63 Treatment for NMS | back 63 stop the antipsychotic and provide supportive care (relax muscles with BZDs, dantrolene or bromocriptine |