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