GK Pharm 2 Exam 2 > Antipsychotics/Lithium- 2 > Flashcards

Antipsychotics/Lithium- 2 Flashcards

(41 cards)

Study These Flashcards
1
Q

ADEs of Clozapine or Haloperidol?

  • Sedation: +
  • EPS: ++++
  • Anticholinergic: +
  • Orthostasis: +
  • Weight gain: +
  • Prolactin: +++
A

Haloperidol

(opposite effects as Clozapine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ADEs of Clozapine or Haloperidol?

  • Sedation: ++++
  • EPS: +
  • Anticholinergic: ++++
  • Orthostasis: ++++
  • Weight gain: ++++
  • Prolactin: +
A

Clozapine

(opposite effects as Haloperidol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main thing Risperidone causes an increase in?

B/c of this, what might you see on physical exam?

A

Increase in Prolactin

Galactorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F: the following side effects are for ALL antipsychotic medicaitons:

Akathisia, Anticholinergic, Glucose intolerance, Hyperlipidemia, Orthostatic hypotension, Hyperprolactinemia, Sedation, Sexual dysfunction, Tardive dyskinesia, Weight gain

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which antipsychotic has agranulocytosis?

A

Clozapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which medication has Sialorrhea (excess drooling) as a side effect?

A

Clozapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which antipsychotic has the following adverse effects:

  1. Bronchospasm
  2. Respiratory distress
  3. Respiratory depression

4. Respiratory arrest

A

Inhaled loxapine

(Can only be administered in approved healthcare facilities registered in REMS program)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which antipsychotic has post injection sedation/delerium syndrome?

A

Long-acting olanzapine pamoate monohydrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 5 examples of dose-dependent extrapyramidal effects caused by antipsychotics?

A

Parkinson like syndrome:

  • Bradykinesia, rigidity, tremor
  • Akathsia, dystonias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 5 treatment options for dose-dependent extrapyramidal effects (parkinson-like syndrome) caused by antipsychotics?

(“BAD AB”)

A
  1. Antimuscarinics (Benztropine, Trihexyphenidyl)
  2. Antihistaminic (Diphenhydramine)
  3. Dopamine Agonist (Amantadine)
  4. Benzos (Lorazepam, Diazepam, Clonazepam)
  5. B-blockers (Propanolol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the two toxicities of antipsychotics?

A
  1. Dose-dependent extrapyramidal effects
  2. Tardive dyskinesias (may appear as early as 6mo, usually years)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the treatment goal for schizophrenia in the first 7 days?

A

Decreased agitation, hostility, anxiety and aggression

Normalization of sleep and eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment goal for schizophrenia during weeks 2 and 3?

A

Improve socialization, self-care and mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the goal of maintenance therapy for Schizophrenia?

A

Avoidance of relapses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Schizophrenia maintenance therapy:

How long should you continue medication after remission of the first psychotic episode?

A

at least 12 months

(many experts recommend tx for at least 5 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Schizophrenia maintenace therapy:

Which group of meds should be tapered slowly before discontinuation to avoid cholinergic rebound?

A

Antipsychotics (especially FGAs and clozapine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Schizophrenia maintenance therapy:

What should you do when switching from one antipsychotic to another?

Study These Flashcards
A

the first should be tapered and discontinued over at least 1 to 2 weeks while the second antipsychotic is initiated and tapered upward

18
Q

The following meds are used for what?

  • Lithium
  • Valproate
  • Carbamazepine
  • Aripiprazole
  • etc
Study These Flashcards
A

Acute mania treatment in Bipolar disorder

19
Q

What are the 4 meds used as maintenance treatment for Bipolar disorder?

Study These Flashcards
A
  1. Lithium
  2. Aripirazole
  3. Olanzepine
  4. Lamotrigine

(LOLA has bipolar disorder)

20
Q

What 2 meds are used to tx bipolar depression?

Study These Flashcards
A
  1. Quetiapine
  2. Lurasidone
21
Q

Bipolar Disorder treatment:

Which two groups of meds may need to be included during initiation because of the slow onset of lithium or valproic acid?

Study These Flashcards
A

Antipsychotics and benzos

22
Q

What can precipitate mania in bipolar patients?

(KNOW)

Study These Flashcards
A

Monotherapy with antidepressants

23
Q

______ appears to preserve or increase the volume of brain structures involved in emotional regulation such as the prefrontal cortex, hippocampus and amygdala, possibly reflecting its neuroprotective effects.

24
Q

At a neuronal level, lithium reduces ______ but increases _______

Study These Flashcards
A

At a neuronal level, lithium reduces excitatory (dopamine and glutamate)** but increases **inhibitory (GABA) neurotransmission

25
T/F: Lithium has a narrow margin of safety
True
26
Lithium is excreted virtually entirely how?
in the urine
27
Toxicities associated with lithium are seen when there is too low of what?
sodium
28
What needs to be closely controlled when prescribing lithium?
sodium
29
Does therapy with Lithium make sense in a high performing atheletes?
No because can't maintain the sodium
30
Does litihium cause sedation?
no
31
Clearance of Lithium is decreased by taking what 2 medications?
Thiazides and NSAIDs
32
What is the first sign of lithium toxicity?
tremor
33
What are the 4 toxicities of Lithium?
1. Tremor (1st sign of toxicity) 2. Edema 3. **Hypothyroidism** 4. Renal dysfunction
34
Lithium is a pregnancy category \_\_\_\_\_
D
35
Where can Lithium substitute for sodium?
In proximal tubule cells and principal cells of the collecting duct in kidney cells
36
* Lithium inhibits GSK-3 leading to increased \_\_\_\_\_\_expression and PGE2 synthesis. * This results in diminished _______ activity and decreased AQP2 levels on apical membrane of principal cells, which leads to increased \_\_\_\_\_\_\_.
* Lithium inhibits GSK-3 leading to increased **_COX-2_** expression and PGE2 synthesis. * This results in diminished **_Vasopressin_** activity and decreased AQP2 levels on apical membrane of principal cells, which leads to increased **_Urination_** (This is Lithium induced nephrogenic diabetes insipidis)
37
How do you treat an acute hypomania episode in a patient with bipolar disorder?
1. optimize current mood stabilizer or initiate one (**Lithium, Valproate, Carbamazepine or SGAs**) 2. +/- Benzos for short term tx of agitation or insomnia
38
How do you treat an acute manic episode in a person with bipolar disorder? (3)
2-3 drug combo (Lithium, valproate, or SGA) + Benzo (Lorazepam or clonazepam) +/- antipsychotic (short term for agitation/insomnia)x
39
What are the 5 general guidelines for treatment of **acute manic or mixed episodes** in a patient with bipolar I disorder?
1. Assess for secondary cuases of mania or mixed states (ex: alcohol, drugs) 2. Discontinue antidepressants 3. Taper off stimulants and caffeine if possible 4. Treat substance abuse 5. Encourage good nutrition, exercise, sleep, stress reduction, etc
40
What are the 4 general guidelines for treatment of an **acute depressive episode** in a patient with bipolar I disorder?
1. Assess for secondary causes of depression (ex: alcohol, drugs) 2. Taper off antipsychotics, benzos or sedative hypnotic agents if possible 3. Treat substance abuse 4. Encourage good nurtition, exercise, sleep, etc
41
How do you treat a severe depressive episode in a patient with Bipolar I disorder
* Optimize current mood stabilizer or initiate mood-stabilizing med (lithium or quetiapine or lurasidone) * If psychosis: initiate antispychotic \*do not combine antipsychotics\*
GK Pharm 2 Exam 2
flashcards
Decks in class (19)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions