Term
| First generation (typical) antipsychotics are better for treating [positive or negative] symptoms of schizophrenia. |
|
Definition
|
|
Term
| Which generation of antipsychotics poses a lesser risk for extrapyramidal symptoms? |
|
Definition
| Second generation (atypicals) |
|
|
Term
| Which of the following is the most likely to cause extrapyramidal symptoms: Chlorpromazine, Thioridazine, Fluphenazine, or Haloperidol? |
|
Definition
|
|
Term
| Which of the following binds LEAST potently to the D2 receptor: Chlorpromazine, Thioridazine, Fluphenazine, or Haloperidol? |
|
Definition
|
|
Term
| What is the maximum daily dose of haloperidol? |
|
Definition
|
|
Term
| Haloperidol is metabolized by which CYP enzymes? |
|
Definition
|
|
Term
| What is the dose conversion factor between oral haloperidol and haloperidol decanoate (IM injection)? |
|
Definition
| Dose conversion: 10-15x daily PO dose qMonth |
|
|
Term
| Which of the following agents is most likely to exhibit orthostasis: Thioridazine, Thiothixene, Fluephenazine, Haloperidol? |
|
Definition
|
|
Term
| Thioridazine is not utilized as a first line agent because of: 1) Retrograde ejaculation, 2) Retinal pigmentary changes, 3) QT interval prolongation, 4) High anticholinergic effects, 5) All of the above |
|
Definition
|
|
Term
| What drug may be given with Haldol or Thorazine to avoid extrapyramidal symptoms? |
|
Definition
|
|
Term
| Which of the following is the first symptom of extrapyramidal symptoms: Acute dystonia, akathisia, pseudoparkinsonism, or tardive dyskinesia? |
|
Definition
|
|
Term
| What is the treatment of choice for acute dystonia? |
|
Definition
| Benztropine OR diphenhydramine |
|
|
Term
| What are the treatments of choice in patients with akathisia? |
|
Definition
|
|
Term
| What are the treatments of choice for pseudoparkinsonism? |
|
Definition
| Benztropine OR trihexyphenidyl |
|
|
Term
| Drastic changes in mental status accompanied by elevated CPK levels are often indicative of what adverse effect antipsychotics? |
|
Definition
| Neuroleptic Malignant Syndrome |
|
|
Term
| Which of the following drugs is not appropriate for treatment of neuroleptic malignant syndrome: bromocriptine, dantrolene, or thiothixene? |
|
Definition
|
|
Term
| Atypical antipsychotics carry a FDA class warning for: |
|
Definition
| Weight gain, hyperglycemia, new onset of DM |
|
|
Term
| Which of the following is the least likely to cause extrapyramidal symptoms: Risperidone, aripiprazole, olanzapine, ziprasidone, clozapine, or quetiapine? |
|
Definition
|
|
Term
| Clozapine has been given a black box warning for what adverse effects? |
|
Definition
| Agranulocytosis and seizure risk (higher doses) |
|
|
Term
| What is the maximum daily dose of clozapine? |
|
Definition
|
|
Term
| What is the effect of concomitant use of phenytoin and clozapine? |
|
Definition
| Decreased clozapine levels (CYP induction by phenytoin) |
|
|
Term
| Concomitant use of carbamazepine and clozapine increases the likelihood of developing: |
|
Definition
|
|
Term
| Concomitant use of clozapine and ciprofloxacin has what effect on clozapine? |
|
Definition
| Increases clozapine levels (Cipro = inhibitor) |
|
|
Term
| What is the effect of cigarette smoking on clozapine levels? |
|
Definition
| Decrease clozapine levels (1A2 induction by smoking) |
|
|
Term
| Which of the atypical antipsychotics is most likely to cause extrapyramidal symptoms? |
|
Definition
|
|
Term
| What is the brand name for IM risperidone? |
|
Definition
|
|
Term
| What is the brand name of the long-acting IM olanzapine? |
|
Definition
|
|
Term
| Zyprexa Relprevv (olanzapine IM) has a warning for what? |
|
Definition
| Post-injection delirium/sedation syndrome (including coma) |
|
|
Term
| How should ziprasidone (Geodon) be administered orally? |
|
Definition
| With food --> increase bioavailability 2x |
|
|
Term
| Many facilities require this baseline test before prescribing Geodon: |
|
Definition
| EKG --> Geodon causes the longest QT prolongation among atypicals |
|
|
Term
| Paliperidone is the major active metabolite of which atypical antipsychotic? |
|
Definition
|
|
Term
| Oral hypoesthesia is a distinct ADR associated with which atypical antipsychotic? |
|
Definition
|
|
Term
| Which atypical antipsychotics are indicated for use in patients with autism? |
|
Definition
| Risperidone, aripiprazole |
|
|
Term
| Which two atypical antipsychotics are indicated for maintenance therapy for bipolar disorder? |
|
Definition
|
|
Term
| Which atypical antipsychotic is also approved as an adjunct in the treatment of major depressive disorder? |
|
Definition
|
|
Term
| Which atypical antipsychotic causes the least amount of weight gain, hyperlipidemia, and DM? |
|
Definition
|
|
Term
| Which atypical antipsychotic exhibits the most significant weight gain, hyperlipidemia, and DM? |
|
Definition
|
|
Term
| True or false: Weight gain associated with atypical antipsychotics is dose-related. |
|
Definition
|
|
Term
| Which atypical antipsychotics are CYP1A2 substrates? |
|
Definition
| Olanzapine, Clozapine, Asenapine |
|
|
Term
| Which atypical antipsychotics are CYP2D6 substrates? |
|
Definition
| Risperidone, clozapine, olanzapine, aripiprazole, iloperidone |
|
|
Term
| Which atypical antipsychotics are CYP3A4 substrates? |
|
Definition
| Clozapine, quetiapine, ziprasidone, aripiprazole, iloperidone |
|
|
Term
| A patient currently being treated with Geodon for schizophrenia approaches your Target Pharmacy counter with a question, because after all, you're a Target pharmacist -- that's what you do. She asks about taking St. John's wort, because she saw an Oprah special on it. What do you tell her? |
|
Definition
Do NOT take SJW, because it will decrease the effects of your Geodon (CYP3A4 induction).
In case you ever become a Target pharmacist, Pepto Bismol is pink because of the bismuth... Just saying'. |
|
|
Term
| Mr. Kingsford, one of your patients for many years, presents to your pharmacy counter with a new prescription for starting dose olanzapine. While waiting for his prescription, he tells you about this great new all charcoal grilled food diet he's been on for the past couple weeks, and that he enjoys nothing more than flipping a burger and smoking a Marlboro. After hearing this, you decide to call Mr. Kingsford's doctor to discuss the script with him. What should your conversation include? |
|
Definition
| Mr. Kingsford has been prescribed the lowest dose of Zyprexa, a CYP1A2 substrate. He informed me that he has been consistently eating charcoal grilled food and smokes cigarettes, both of which induce CYP1A2. Thus, he is likely to experience sub-therapeutic doses of Zyprexa and should be monitored closely for ineffective treatment. |
|
|
Term
| What pregnancy category is clozapine? |
|
Definition
|
|
Term
| All atypical antipsychotics are pregnancy category C, except: |
|
Definition
|
|
Term
| All typical antipsychotics are pregnancy category ___. |
|
Definition
|
|
