Session 4 Pharm- 1 Word Scramble
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Question | Answer |
What type of disorder are the following schizophrenia, manic phase of bipolar affective disorder, schizoaffective disorders, severe states of agitation | psychotic disorders |
When does schizophrenia typically start | 15-45 yrs |
Who tends to present with schizophrenia earlier males or females | males 20s vs females 30s |
What are the subtypes of schizophrenia | paranoid, disorganized, catatonic, undifferentiated, residual |
Does subtyping of schizophrenia help you tailor the pharmacotherapy better | no |
Are the following positive or negative symptoms of schizophrenia- delusions, hallucinations, disorganized speech, catatonia | positive |
Affective flattening, alogia, avolition and anhedonia are positive or negative signs of schizophrenia | negative |
Acute schizophrenia and in younger patients is marked more by positive or negative symptoms | positive symptoms |
Chronic Schizophrenia and older pts with schizophrenia have more positive or negative symptoms | predominant negative symptoms |
Which symptoms positive or negative of schizo are generally more troubling to the pt and indicated a poor prognosis | negative symptoms |
What is the underlying neurochemistry basis for schizophrenia | excess of dopamine in the mesolimbic and mesocortical pathways |
What are the three treatment phases of schizophrenia | acute phase (predominant positive symptoms, Stabilization phase, stable phase |
Antipsychotics are split into two large groups what are they | typical and atypical |
are D2 receptors typical or atypical antipsychos | Typical |
Which type of antipsychotic is better at treating negative symptoms typical or atypicals | atypicals |
Which antipsychotic has more motor side effects and hyperprolactinemia | typicals |
Which antipsychotic group atypical or typical targets both 5HT2a receptors and D2 receptors | Atypicals |
The typical antipsychos are further subdivided into what two groups | phenothiazines and non phenothiazines |
What type of drug is chlorpromazine (Thorazine) | Typical Phenothiazine antipsychotic |
What type of drug is Thioridazine (Mellaril) | Typical Phenothiazine antipsychotic |
What type of drug is Perphenazine (Trilafon) | Typical Phenothiazine antipsychotic |
What type of drug is Fluphenazine (Prolixin) | Typical Phenothiazine antipsychotic |
What type of drug is Thioxanthene (Navane) | Non Phenothiazine Typical antipsychotic |
What type of drug is Haloperidol (Haldol) | Non Phenothiazine Typical antipsychotic |
What type of drug is Molindone (Moban) | Non Phenothiazine Typical antipsychotic |
What type of drug is Pimozide (Orap) | Non Phenothiazine Typical antipsychotic |
What is the MOA of typical antipsychotics meds | potent D2 receptor family blockers, tx positive symptoms>negative (Less effective in tx of negative symptoms) |
What are the side effects of typical antipsychotics | motor side effects (extrapyramidal symptoms) because of blockade of dopamine receptors in nigrostriatal pathway. Neuroendocrinology side effects from blockade of tuberoinfundibular pathway |
Pt is taking an typical antipsychotic and has acute dystonia, bradykinesia, rigidity, postural imbalance and akathisia what are these side effects called | acute extrapyramidal symptoms |
What are the chronic extrapyramidal symptoms | tardive dyskinesia, Tardive Dystonia |
What tx can you give to correct for the extrapyramidal symptoms of the typical antipsychos | anticholinergic drugs- Procyclidine, orphendadrine, benztropine, Benadryl |
Pt is having extrapyramidal side effects from their typical antipsychotic beside anticholinergic drugs what can you do to address the s/e | reduce the dose, switch to an atypical antipsychotic |
Pt develops Tardive Dyskinesia you decide to stop their typical antipsychotic will this get rid of their s/e | no Tardive symptoms will persist even after drugs have been stopped |
What drug can be given to improve the tardive dyskinesias and Dystonia that can develop with typical antipsychos | clozapine |
Pt is taking a typical antipsychotic and the come in complaining of discharge from their breast what is going on | Typical Antipsychos block D2 receptors in tuberoinfundibular pathway that takes out dopamine inhibition of prolactin and you get high serum levels of prolactin that can cause discharge |
Typical Antipsychos can also cause Autonomic and Histaminergic s/e what are they | dry mouth, difficulty urinating, constipation, blurred vision, confusion, ortho hypotension, sedation from blockade of muscarinic receptors, Alpha Adrenoreceptor and H1 histamine receptor blockade |
Why is haloperidol typically the typical antipsychotic used to tx acute schizophrenia | has less sedation, low anti muscarinic effects and very little ortho hypotension than other typicals and is great to control positive symptoms common in acute schizophrenia |
Pt needs long term tx for schizophrenia are you more likely to use a typical or atypical antipsychotics | Atypical Antipsychotic |
What type of drug is clozapine (Clozaril) | Atypical Antipsychotic |
What type of drug is Olanzapine (Zyprexa) | Atypical Antipsychotic |
What type of drug is Risperidone (Risperdal) | Atypical Antipsychotic |
What type of drug is Quetiapine (Seroquel) | Atypical Antipsychotic |
What type of drug is Ziprasidone (Geodon) | Atypical Antipsychotic |
What type of drug is Aripiprazole (Abilify) | Atypical Antipsychotic |
What s/e of atypical antipsychos and typical antipsychos may be especially concerning for pts self image | weight gain |
Which atypical antipsychos don’t cause as much weight gain | Ziprasidone (Geodon) and Aripiprazole (Abilify) |
What atypical antipsychotic has limited place in therapy due to fatal neutropenia | clozapine |
When can you use clozapine | unresponsive to two other neuroleptics or has tardive dyskinesia |
What must you do prior to and while administering clozapine | Carefully monitor CBCs |
T/F Clozapine causes hypo salivation | F it actually causes hyper salivation opposite of the other antipsychos that cause dry mouth |
What is the most commonly used atypical used during an acute psychotic break | Olanzapine (Zyprexa) |
What s/e is the most concern with Olanzapine (Zyprexa) | Causes weight Gain more than other antipsychos and can cause EPS at increased doses |
You don't want to give your pt Olanzapine or Haloperidol what is the next most common choice even though it also causes EPS, Hyperprolactinemia, and weight gain (though not as much as olanzapine) | Risperidone (Risperdal) |
Pt has Parkinson's disease and psychosis what drug would be a popular choice to tx them | Quetiapine (Seroquel) causes somnolence and postural hypotension though |
What place in therapy does aripiprazole (Abilify) take | can tx depression as well and has minimal weight gain compared to other atypicals and typical antipsychos |
When should you not use Ziprasidone (Geodon) a newer atypical antipsychotic | it can cause cardiac arrhythmias in pts with baseline risk factors (elderly, preexisting cardiac disease, pts on diuretics or medication that prolongs QT interval) |
Created by:
smaxsmith
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