Term
| Psychotrophic Regulations: Gradual dose reductions |
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Definition
| q 6 months for 1st year then annually thereafter unless clinically contraindicated; q 3 months if sedative hypnotic |
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Term
| change in patient behavior later in the day (time varies) |
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Definition
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|
Term
| major classes of anticholinergic medications |
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Definition
| antihistamins, overactive bladder agents, antinausea/motion sickness, some antipsychotics |
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Term
| Pharmacological choices for treating BPSD |
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Definition
| anti-psychotics, anti-anxiety, anti-convulsants, anti-depressants, sleep agents, cognitive enhancers, beta-blockers |
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|
Term
|
Definition
| cognitive enhancers, antidepressants, |
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|
Term
|
Definition
| acetylcholinesterase inhibitors: watch for side effects, which are GI and bradycardia and bronchoconstriction (more critical); Memantine |
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|
Term
|
Definition
| Sertraline, Citalopram typically preferred SSRIs in elderly |
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|
Term
|
Definition
|
|
Term
| SSRi: 2nd most stimulating |
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Definition
|
|
Term
| SSRI: wild card (interactions) |
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Definition
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Term
|
Definition
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Term
|
Definition
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|
Term
| useful for depression, inducing sleep, appetite stimulation, may be helpful for patients with mixed symptoms |
|
Definition
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|
Term
|
Definition
| more drowsiness at lower dose; norepinephrine greater effect at higher doses; strong H2 blocker but low anticholinergic |
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|
Term
| may be useful in more mild cases or sensitive patients with aggressiveness |
|
Definition
|
|
Term
| aggressiveness: may be calming for some patients, low doses typically avoid orthostatic hypotension, still have significant drowsiness |
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Definition
|
|
Term
| aggressiveness: possible significant CNS effects: "slowing down" the CNS; drug interactions, very effective for some patients |
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Definition
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|
Term
| may be effective for anxiousness/lack of sleep; can cause a paradoxical response |
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Definition
|
|
Term
| benzos: intermediate acting |
|
Definition
| more predictable metabolism (lorazepam, temazepam, oxazepam) |
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|
Term
|
Definition
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|
Term
| black box warning for atypical antipsychotic |
|
Definition
| increased risk of death (stroke, heart failure, sudden death, infections) |
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|
Term
| antipsychotic: Risperidone |
|
Definition
|
|
Term
| antipsychotic: Olanzapine |
|
Definition
| may worsen psychosis in some patients, okay data for agitation |
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|
Term
| antipsychotic: Quetiapine |
|
Definition
| lacks evidence; active metabolite is anticholinergic; still used in practice |
|
|
Term
| primary neurotransmitter blocked by antipsychotics |
|
Definition
|
|
Term
| have a broader effect on additional neurotransmitters |
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Definition
|
|
Term
| 1st generation antipsychotics adverse effects |
|
Definition
| parkinsonism, dystonia, tardive dyskinesia, akathisia (not common in elderly) |
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|
Term
| antipsychotic highest side effect of sedation |
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Definition
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|
Term
| antipsychotic highest side effect of increased triglycerides (also causes quite a bit of sedation) |
|
Definition
|
|
Term
| antipsychotic has the most movement side effects |
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Definition
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|
Term
| antipsychotic causes the most weight gain/glucose incrrease |
|
Definition
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|
Term
| antipsychotic highest rate of urinary incontinence, UTI |
|
Definition
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|
Term
| Avoid these in patients with dyslipidemia, obesity, diabetes |
|
Definition
| olanzapine, clozapine, and 1st generation antipsychotics |
|
|
Term
| Hyperprolactemia in antipsychotic use |
|
Definition
| risperidone- most likely; short term: gynecomastia nad galactorrhea; longer term: osteopenia, breast and endometrial cancer |
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|
Term
| antipsychotics block dopamine resulting in.. |
|
Definition
| nausea, parkinsonism effects |
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|
Term
|
Definition
|
|
Term
| Generally preferred antipsychotics |
|
Definition
| Atypicals = quetiapine, risperidone, olanzapine |
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|
Term
| antipsychotics effective for positive symptoms; less expensive, may be useful for short term aggressive behavior |
|
Definition
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|
Term
| Frontotemporal Dementia: Paroxetine |
|
Definition
| may worsen symptoms (anticholinergic) |
|
|
Term
| Frontotemporal Dementia: Trazodone |
|
Definition
| significant behavioral improvement; no change in cognition; fatigue, drowsiness, hypotension |
|
|
Term
| Frontotemporal Dementia: Cholinesterase inhibitors |
|
Definition
|
|
Term
| Frontotemporal Dementia: antipsychotics |
|
Definition
| increased EPS sensitivity |
|
|
Term
| Frontotemporal Dementia: stimulants |
|
Definition
| dextroamphetamine may help |
|
|
Term
| try to avoid antipsychotics use if possible; if needed: cloazapine, quetiapine best agents |
|
Definition
|
|
Term
| Lewy body dementia: try first |
|
Definition
| Cholinesterase inhibitors; may reduce fluctuations in consciousness and hallucinations |
|
|
Term
| Lewy body dementia; antipsychotics |
|
Definition
| significantly more sedation, confusion, and rigidity; modest response with olanzapine and quetiapine |
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|
Term
|
Definition
| Risperidone has warning regarding titration |
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|
Term
|
Definition
| Abilify, Risperdal, Seroquel, Zyprexa, and Haldol titrate more slowly |
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|
Term
|
Definition
| mental status changes, rigidity, hyperthermia, and autonomic and neuromuscular hyperactivity; potentially fatal |
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|
Term
| Neuroleptic Malignant Syndrome |
|
Definition
| similar symptoms to serotonin syndrome but patients are more likely to have rigidity |
|
|
Term
| caused by dopamine-blocking agents or withdrawal of dopaminergic meds |
|
Definition
| neuroleptic malignant syndrome |
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