| Question | Answer |
| 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) |
