Antipsychotics and Their Use
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Questions and Answers

What is the primary use of Haloperidol?

  • To induce sedation during surgery
  • To control positive symptoms of schizophrenia (correct)
  • To treat anxiety disorders
  • To manage depression

What is a significant side effect of Olanzapine?

  • Weight gain (correct)
  • Excessive sweating
  • Severe sedation
  • Increased energy

Which medication requires careful monitoring for agranulocytosis?

  • Diphenhydramine
  • Clonazepam
  • Propranolol
  • Clozapine (correct)

What is a common side effect of benzodiazepines such as Lorazepam?

<p>Sedation (D)</p> Signup and view all the answers

What type of medication is Fluoxetine classified as?

<p>SSRI (A)</p> Signup and view all the answers

What is the mechanism of action for Atypical antipsychotics like Ziprasidone?

<p>Increase serotonin and decrease dopamine (A)</p> Signup and view all the answers

What symptom should prompt immediate action when using neuroleptic medications?

<p>High fever and tremors (B)</p> Signup and view all the answers

Which of the following is a side effect of Diphenhydramine?

<p>Dry mouth (B)</p> Signup and view all the answers

What should be monitored with the use of Ziprasidone?

<p>QT interval on EKG (C)</p> Signup and view all the answers

What is an important consideration with the use of Midazolam?

<p>It has a high potential for addiction. (A)</p> Signup and view all the answers

What are the potential side effects of Amitriptyline?

<p>Decreased blood pressure and sedation (B)</p> Signup and view all the answers

What must be monitored in patients taking Lithium?

<p>Kidney function and thyroid function (C)</p> Signup and view all the answers

Which medication is a known contraindication for patients undergoing alcohol withdrawal?

<p>Bupropion (B)</p> Signup and view all the answers

Which medication can cause hypertensive crisis if taken with tyramine-rich foods?

<p>Selegiline (B)</p> Signup and view all the answers

What is the therapeutic range for Divalproex Sodium?

<p>50-125 mcg/mL (B)</p> Signup and view all the answers

Which of the following is a potential risk associated with CNS stimulants?

<p>Growth suppression and hallucinations (C)</p> Signup and view all the answers

What management is necessary for a patient taking MAOIs?

<p>Following a low-tyramine diet (C)</p> Signup and view all the answers

What class of drugs does Venlafaxine belong to?

<p>SNRI (B)</p> Signup and view all the answers

Which medication is specifically indicated for performance anxiety?

<p>Propranolol (D)</p> Signup and view all the answers

Which side effect is commonly associated with SSRIs?

<p>Dry mouth (A)</p> Signup and view all the answers

Which antipsychotic is associated with agranulocytosis?

<p>Clozapine (C)</p> Signup and view all the answers

What is a common side effect experienced with Bupropion?

<p>Anxiety (D)</p> Signup and view all the answers

Which pharmacological treatment is primarily used for opioid overdose?

<p>Naloxone (D)</p> Signup and view all the answers

How should Lamotrigine be administered to minimize the risk of serious side effects?

<p>Starting low and increasing dose slowly (C)</p> Signup and view all the answers

Flashcards

Haloperidol (typical antipsychotic)

First-generation antipsychotic used to manage positive symptoms of schizophrenia and related disorders, like hallucinations. It can also be used in Tourette's Syndrome.

EPS (Extrapyramidal Symptoms)

Muscle stiffness, tremors, or uncontrolled movements, often a side effect from antipsychotics.

Neuroleptic Malignant Syndrome (NMS)

A severe, potentially life-threatening reaction to certain antipsychotics, characterized by high fever, tremors, and muscle rigidity.

Olanzapine (atypical antipsychotic)

An antipsychotic that controls both positive and negative symptoms of schizophrenia. Negative symptoms like lack of motivation, also called flattened affect are addressed.

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Benzodiazepines

A category of sedative drugs used to treat anxiety, inducing relaxation. They are commonly prescribed to accompany antipsychotics to control agitation and aggression.

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Lorazepam (Ativan)

A short-acting benzodiazepine, rapidly effective for treating anxiety, used alongside antipsychotics for behavioral control.

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Fluoxetine (Prozac)

An SSRI (selective serotonin reuptake inhibitor). Used primarily for depression, affecting serotonin levels. Can be used for anxiety disorders.

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Propranolol (Inderal)

A beta-blocker used for managing the physical symptoms of anxiety, like tremors and sweating. It doesn't directly treat the anxiety itself.

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Atypical Antipsychotics

A class of antipsychotic medications that differ from typical antipsychotics in their action on neurotransmitters in the brain.

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Tardive dyskinesia

A side effect of some antipsychotic medications characterized by involuntary movements, especially in the face and mouth.

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Amitriptyline use

An older Tricyclic Antidepressant (TCA) used for sleep or when other antidepressants don't work; also used for neuropathic pain and fibromyalgia.

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MAOI side effects

Includes orthostatic hypotension, dizziness, drowsiness, insomnia, and sexual dysfunction, plus a significant risk of hypertensive crisis from tyramine-containing foods.

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SSRI first-line use

Fluoxetine, sertraline, and citalopram are first-line treatments for depression due to fewer side effects than TCAs, taken in the morning, and gradual effect.

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SNRI side effects

Venlafaxine and duloxetine may cause tachycardia, hypertension, insomnia, anxiety, and GI issues, though potentially less than SSRIs.

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Bupropion MOA

Bupropion affects dopamine and norepinephrine levels in the brain, used for depression, ADHD, and smoking cessation.

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Lithium therapeutic range

0.6-1.2 mEq/L; above 1.5 mEq/L is toxic.

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Lithium side effects

Tremors, kidney problems, and potential toxicity if blood levels exceed the therapeutic range.

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Divalproex Sodium range

50-125 mcg/mL; toxic above 150mcg/ml.

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Lamotrigine side effect

Potentially life-threatening rashes (Stevens-Johnson syndrome) especially within the first few weeks.

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Methylphenidate type

A short-acting stimulant used for ADHD; also has longer-lasting forms.

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Atomoxetine use

A non-stimulant ADHD treatment; second-line if stimulants cause too many side effects.

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Clonidine SE

Low blood pressure, drowsiness, and potential rebound hypertension.

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Naltrexone use

Reduces alcohol cravings, decreases alcohol effect.

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Disulfiram effect

Causes severe sickness if patient consumes alcohol, used to deter alcohol use.

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Study Notes

Haloperidol

  • First-generation typical antipsychotic, controls positive symptoms
  • Used for hallucinations, schizophrenia, Tourette's
  • Often given with benzodiazepines like Lorazepam to manage aggressive behavior
  • Side effects include extrapyramidal symptoms (EPS), tardive dyskinesia, sedation
  • Risk of neuroleptic malignant syndrome (high fever, tremors)
  • Use benztropine to reduce EPS

Diphenhydramine

  • Antihistamine, first-generation
  • Side effects include sedation, urinary retention
  • Used to prevent dystonic reactions
  • Sedating effect

Midazolam

  • Acts quickly (within minutes)
  • High addiction potential, not for long-term use
  • Side effects include sedation and suppression of vital functions
  • Avoid skipping doses and dangerous tasks

Olanzapine

  • Second-generation atypical antipsychotic
  • Treats both positive and negative symptoms of schizophrenia
  • Side effects include weight gain, decreased libido, neutropenia
  • Monitor blood sugar and infection symptoms

Ziprasidone

  • Atypical antipsychotic
  • Balances dopamine levels in the brain
  • Treat schizophrenia

Anti-Anxiety Medications

Hydroxyzine (Atarax, Vistaril)

  • Antihistamine, PRN
  • Takes 15-30 minutes to work
  • Side effects include dry mouth and drowsiness
  • Dose: 25-50 mg (max 100 mg) four times daily

Lorazepam (Ativan)

  • Benzodiazepine (short-intermediate acting), PRN
  • Takes 20-40 minutes to work, lasts 4–6 hours
  • Side effects include drowsiness and sedation
  • Dose: 0.5-2 mg, 2-3 times daily (max 10 mg/day)

Clonazepam (Klonopin)

  • Benzodiazepine (intermediate-long acting), PRN
  • Takes 20-40 minutes to work and lasts 6-12 hours
  • Side effects include ataxia, dizziness, drowsiness
  • Dose: 0.25-1 mg, 1-2 times daily (maximum 4 mg per day)

Fluoxetine (Prozac)

  • Selective serotonin reuptake inhibitor (SSRI)
  • May take 2-12 weeks to see full effect
  • Side effects include decreased libido, sexual dysfunction, dry mouth, insomnia
  • Dose: 10-20 mg once daily (maximum 60 mg per day)

Propranolol (Inderal)

  • Beta-blocker, PRN
  • Takes 30-60 minutes to work, lasts 6-12 hours
  • Side effect includes hypotension
  • Dose: 10-20 mg every 30-60 minutes before stressful events (maximum 4 mg daily)

Antipsychotics (First Generation/Typical)

  • Haloperidol, Fluphenazine
  • Decrease dopamine in the brain

Antipsychotics (Second Generation/Atypical)

  • Aripiprazole, Clozapine, Olanzapine, Risperidone, Quetiapine, Ziprasidone
  • Decrease dopamine and increase serotonin
  • Side effects include EPS, metabolic syndrome, neuroleptic malignant syndrome (NMS), potentially agranulocytosis

Other Medications

  • Amitriptyline: Tricyclic antidepressant (TCA)- Used for sleep or other situations where other medications didn't work
  • Lithium: Mood stabilizer. Therapeutic range is 0.6 - 1.2 mEq/L Toxicity is above 1.5 mEq/L.
  • Methylphenidate: CNS stimulant, short & intermediate acting.
  • Dextroamphetamine/amphetamine: CNS stimulant, immediate release medication
  • Atomoxetine: Non-stimulant, works in cases where stimulants aren't tolerated or are causing too many side effects

Withdrawal from Nicotine

  • Nicotine gum, lozenge, patch. Follow instructions for proper use.

Withdrawal from Alcohol

  • Use medications like Naltrexone to reduce craving and prevent relapse.
  • Use other medications to manage symptoms of withdrawal. Follow instructions for proper use.
  • Avoid Bupropion, given the increased risk of seizures in combination with alcohol withdrawal.

Other Important Notes

  • Many medications have serious side effects. It is crucial to monitor patients closely and follow instructions carefully to manage and treat side effects.
  • Always consult with a doctor for diagnosis and treatment plans.

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Description

This quiz covers the key aspects of various antipsychotic medications, including first-generation and second-generation drugs like Haloperidol and Olanzapine. It addresses their indications, mechanisms, side effects, and the management of related symptoms. Test your knowledge on the pharmacology and clinical applications of these essential psychiatric medications.

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