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Typical (1st gen) MOA
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Atypical (2nd gen) MOA
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Schizophrenia-Drugs

QuestionAnswer
Typical (1st gen) MOA block DA2, anticho, antihis, alpha-block, but NOT Serotonin. Effect (+)Sx
Atypical (2nd gen) MOA block 5HT2(SEROTONIN) and DA, effect both (+/-) Sx
SEs of anti-spychotics WASH MEN: Wt gain, Anticholi, Sedation, Hypotension, Movement disorder, EPS, NMS
Cholinergic SE SLUDGE: Salivation, Lacrimaition, Urination, Defecation, GI motility, Excretion
Anticholinergic SE Anti-SLUDGE, Tachy
Dystonia Tx IV diphenhydramine 25-50mg
Akathisia Tx Propranolol 30-100 mg QD
Pseudopakinsonism Bentropine, Trihexyphenidyl, Diphenhydramine, or Amantadine
EPS Dystonia (painful muscle spasm) + akathisia(restleless) + Paeudoparkinson
Tardive Dyskinesia (TD) Sx Hypersensitivity Rxn: Tongue, lip, jaw, face & extremity movement
How to manage TD 1. use lowest dose, 2. use CLOZAPINE
NMS management LIFE THREATENING, 1. D/C provide supportive theapy(IV fuid, cooling), 2. incre DA: DA agonist (Bromocriptine), 3. Dantrolene(muscle relax)(1mg/kg rapid IV push)
Typical used for Tourette's only pimozide (Orap)
IM antipsychotic of rapid tranquilization ZHOA = Zipresidone, Haloperidol, Olanzapine, Abilbify
antisychotic for Deconate (long dosing interval) 2 typical + 1 atypical: Haldol (10-15x oral dose MONTHLY), Fluphenazine(Prolixin)(oral x 25 Q2W), Risperidal Consta(Q2W, >18yo)- HRF
Clozapine SE Agranulocytosis, do not give WBC < 3.500/mm3, check CBC qwx6monthd, q2wksx6month, then q month.
Clozapine benefit NOT cause EPS, can Tx TD
Risperidone benefit OD, tabs, liquid, and Depot
Only atipical with QD dose Olanzapine (Zyprexa, Zydis) 5-10mg QD, max20, Zydis is OD (bup on top of the tongue)
Olanzapine most SE "O" = wt. gain, hyperglyemia, hyperlipidimia. Monotor wt, glucose, lipid.
Quetiapine special SE Seroquel, Seroquel XR/ Cataract (EYE)/ lowest anticholinergic of all atypical
Ziprasidone (Geodon)dose 20mg (max 80) PO BID W/FOOD "Zipra eating",
Ziprasidone SE QT prolong
Aripiprazole indication Abilify/ Schezo, Bipolar, MDD
Abilify dose 10-15 (max 30)mg QD
Abilify advantage Long t1/2 (QD), better SE profile
Invega Paliperidone/ active metabolite of RISPERIDONE/
Invega dose ER tabs(3,6,9mg)-OROS, 3-12 mg QD, max=6 for mild RF, max=3 for severe RF
Invega blokage DA2, 5HT2, & Alpha2(like typical) blocker
Invega special SE prolong corretted QT (QTc)
Created by: thuytaimi
 

 



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