S/E ANTIPSYCHOTICS

Question 1

Affects cranial nerve III, VII, IX, X

Answer 1

ANTICHOLINERGIC SIDE EFFECTS

Question 2

Manifestations of ANTICHOLINERGIC SIDE EFFECTS

Answer 2

Mnemonic: “DRY & BLIND”

D – Dry mouth / Dry eyes
R – Reduced sweating (Anhidrosis)
Y – Your memory ↓

B – Blurred near vision
L – Light sensitivity (photophobia)
I – Increased heart rate (tachycardia)
N – Nasal congestion
D – Difficulty urinating/retention & constipation

Question 3

management of anticholinergic side effects

Answer 3

Management Mnemonic: “WATER–FIBER–SAFETY”

Water: sips, sugar-free candy
Fiber: fruits, grains, stool softeners
Safety: avoid heat, no driving/machinery
Eyes: sunglasses, reassure vision returns, pilocarpine drops
Urine: void often, privacy, running water

Question 4

Anti-Adrenergic Side Effects

Answer 4

Mnemonic: “LOW & FAST”

• LOW BP (orthostatic hypotension)
• FAST HR (reflex tachycardia)

Question 5

Management ANTI-ADRENERGIC SIDE EFFECTS

Answer 5

“SLOW & SAFE”

a. Slow position changes
b. Safe environment (fall precautions)
c. Fix hypotension → tachycardia resolves

Question 6

In ENDOCRINE SIDE EFFECTS, inhibition of dopamine causes ___________

Answer 6

Hyperprolactinemia

Question 7

In ENDOCRINE SIDE EFFECTS, Metabolic syndrome or insulin resistance syndrome seen with use of atypical antipsychotics leading to _______________

Answer 7

type 2 diabetes mellitus

Question 8

HYPERPROLACTINEMIA in MEN

Answer 8

a. NO SEX → ↓ libido, impotence
b. BOOBS → gynecomastia
c. FEM → feminization, ↓ sperm

Question 9

HYPERPROLACTINEMIA in WOMEN

Answer 9

a. NO PERIOD (amenorrhea)
b. NO SEX → ↓ libido
c. Changes in menstrual cycle
d. MILK (galactorrhea)
e. BONES ↓ (osteoporosis risk)

Question 10

METABOLIC SYNDROME in ENDOCRINE S/E

Answer 10

Metabolic Syndrome Mnemonic: “HOLD WISH”

Hypertension
Obesity
Lipid ↑
Diabetes (hyperglycemia)

Weight gain
Insulin resistance
Stroke/clot risk
Hypercoagulation

Question 11

Sexual Side Effects of Antipsychotic drugs

Answer 11

“3 D’s”

Desire ↓
Dysfunction (erection)
Disordered ejaculation

Question 12

GIT SIDE EFFECTS of ANTIPSYCHOTIC DRUGS

Answer 12

Mnemonic: “CLOZ-OLAN = CHONKY”

• Clozapine & Olanzapine → weight gain
• Carb cravings

Question 13

Management of GIT SIDE EFFECTS of ANTIPSYCHOTIC DRUGS :

Answer 13

“NO PILLS, SMART MEALS”

• Diet counseling
• No diet pills

Question 14

OTHER SIDE EFFECTS of ANTIPSYCHOTIC DRUGS

Answer 14

QT Prolongation Mnemonic: “DROP the QT”

(Droperidol, Thioridazine, Mesoridazine)
– QT ↑ → torsades de pointes → sudden death

Question 15

SIDE EFFECTS of ANTIPSYCHOTIC DRUGS

CLOZAPINE
- Can cause _____________________

Answer 15

AGRANULOCYTOSIS: “CLOZA = NO WBCs”

Fever
Sore throat
Malaise
Leukopenia

Question 16

SIDE EFFECTS of ANTIPSYCHOTIC DRUGS

CLOZAPINE

Answer 16

Monitoring: “BASELINE → WEEKLY”

• Baseline WBC + differential
• Weekly WBC during therapy
• Continue 4 weeks after stopping