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Questions and Answers
The missing word in the statement 'Every prime number is an _____ number' is 'even'.
The missing word in the statement 'Every prime number is an _____ number' is 'even'.
False
The value of the expression $6(2 + 3)$ equals $30$.
The value of the expression $6(2 + 3)$ equals $30$.
False
In every triangle, the sum of the angles is equal to $180$ degrees irrespective of the shape.
In every triangle, the sum of the angles is equal to $180$ degrees irrespective of the shape.
True
The statement 'All even numbers are divisible by $5$' is true.
The statement 'All even numbers are divisible by $5$' is true.
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The square root of $49$ is $7$, which makes the statement 'The square root of $49$ is odd' true.
The square root of $49$ is $7$, which makes the statement 'The square root of $49$ is odd' true.
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A dosage of 150mg of paliperidone LAI for 1-monthly administration is equivalent to 350mg for 3-monthly administration.
A dosage of 150mg of paliperidone LAI for 1-monthly administration is equivalent to 350mg for 3-monthly administration.
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To ensure an even distribution of the suspension, a loose wrist should be maintained for at least 10 seconds.
To ensure an even distribution of the suspension, a loose wrist should be maintained for at least 10 seconds.
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The equivalent dose of 75mg of paliperidone LAI for a 3-monthly administration is 263mg.
The equivalent dose of 75mg of paliperidone LAI for a 3-monthly administration is 263mg.
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The dosing table for paliperidone LAI indicates a direct relation where higher monthly doses correspond to lower quarterly doses.
The dosing table for paliperidone LAI indicates a direct relation where higher monthly doses correspond to lower quarterly doses.
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For the 1-monthly administration of paliperidone LAI, a dose of 50mg is equivalent to a 3-monthly dose of 175mg.
For the 1-monthly administration of paliperidone LAI, a dose of 50mg is equivalent to a 3-monthly dose of 175mg.
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Paliperidone palmitate is available only as a monthly long-acting injection.
Paliperidone palmitate is available only as a monthly long-acting injection.
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The peak concentration of paliperidone is observed, on average, 28% higher in the gluteal muscle compared to the deltoid muscle.
The peak concentration of paliperidone is observed, on average, 28% higher in the gluteal muscle compared to the deltoid muscle.
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The two initiation doses of paliperidone should be administered via the intravenous route.
The two initiation doses of paliperidone should be administered via the intravenous route.
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Improvement in psychotic symptoms may be observed as quickly as day 4 after administration of paliperidone.
Improvement in psychotic symptoms may be observed as quickly as day 4 after administration of paliperidone.
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The maintenance dose of paliperidone palmitate should be higher than the equivalent dose of oral paliperidone or risperidone.
The maintenance dose of paliperidone palmitate should be higher than the equivalent dose of oral paliperidone or risperidone.
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No test dose is required for paliperidone palmitate administration.
No test dose is required for paliperidone palmitate administration.
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Patients should receive at least 12 injections a year to minimize the risk of relapse.
Patients should receive at least 12 injections a year to minimize the risk of relapse.
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The second initiation dose of paliperidone can only be given on day 8 after the first dose.
The second initiation dose of paliperidone can only be given on day 8 after the first dose.
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Paliperidone LAI has been shown to decrease prolactin levels compared to haloperidol depot.
Paliperidone LAI has been shown to decrease prolactin levels compared to haloperidol depot.
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The average monthly dose of haloperidol used in practice is approximately 75 mg.
The average monthly dose of haloperidol used in practice is approximately 75 mg.
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Paliperidone 3-monthly is indicated for patients who have been stable on paliperidone 1-monthly for less than four months.
Paliperidone 3-monthly is indicated for patients who have been stable on paliperidone 1-monthly for less than four months.
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Paliperidone 3-monthly has a superior tolerability profile compared to the 1-monthly formulation.
Paliperidone 3-monthly has a superior tolerability profile compared to the 1-monthly formulation.
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In studies, aripiprazole showed clinically meaningful improvements in quality of life compared to paliperidone.
In studies, aripiprazole showed clinically meaningful improvements in quality of life compared to paliperidone.
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The bioavailability of Paliperidone palmitate is 28%.
The bioavailability of Paliperidone palmitate is 28%.
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Both paliperidone and aripiprazole LAIs improved quality of life in patients with psychosis and substance use disorders.
Both paliperidone and aripiprazole LAIs improved quality of life in patients with psychosis and substance use disorders.
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For switching to paliperidone 3-monthly, the last two doses of paliperidone 1-monthly should be adjusted to ensure a correct maintenance dose.
For switching to paliperidone 3-monthly, the last two doses of paliperidone 1-monthly should be adjusted to ensure a correct maintenance dose.
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Study Notes
Paliperidone Palmitate Long-Acting Injection
- Paliperidone palmitate, a long-acting injection, is available in monthly and 3-monthly formulations.
- It is the ester prodrug of paliperidone, which is the main active metabolite of risperidone.
- The ester is broken down in the muscle by esterases and then absorbed into the bloodstream.
Paliperidone LAI 1-monthly
- The average peak concentration is 28% higher after an injection into the deltoid muscle compared to the gluteal muscle.
- The two initial doses (deltoid) help achieve therapeutic levels quickly, with improvement in symptoms seen as early as day 4.
- The manufacturer recommends administering maintenance doses up to 7 days before or after the monthly time point.
Paliperidone LAI 1-monthly Administration
-
Initiation:
- Day 1: 150mg IM (deltoid only)
- Day 8 (± 4 days): 100mg IM (deltoid only)
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Maintenance:
- 50-150mg IM (deltoid or gluteal)
Key Points
- No test dose is needed for paliperidone palmitate, but patients should be stable on or have previously responded to oral paliperidone or risperidone.
- The median time to reach maximum plasma concentrations is 13 days.
- Patients receiving fewer than 12 injections per year have an increased risk of relapse.
- Correct dosing is crucial to the effectiveness of paliperidone LAI.
Paliperidone LAI Comparison with Haloperidol Depot
- Paliperidone LAI and haloperidol depot were equally effective in preventing relapse.
- Paliperidone caused more weight gain, increased prolactin levels, and showed a trend towards higher tardive dyskinesia.
- The average dose of haloperidol used was around 75 mg a month, which is uncommon in clinical practice.
Paliperidone LAI 3-monthly
- It is indicated for clinically stable patients on paliperidone LAI 1-monthly (preferably for at least four months) who do not require dose adjustments.
- The last two monthly doses should remain unchanged before switching to the 3-monthly dose to ensure the maintenance dose is correct.
- It has a similar tolerability profile to the 1-monthly preparation and is non-inferior in terms of relapse rate.
- It offers advantages for patients, including fewer injections and less focus on illness.
- It does not impact interaction frequency with healthcare professionals, but regular contact should be maintained.
Paliperidone LAI and Aripiprazole LAI Comparisons
- Two studies compared monthly paliperidone LAI with aripiprazole LAI.
- The first study, a randomized trial, found aripiprazole superior in improving quality of life in the short term, but the aripiprazole group included more younger patients.
- The second study compared the two LAIs in patients with psychosis and substance use disorders.
- Both LAIs improved quality of life and reduced substance cravings, with aripiprazole showing slightly better results, although the difference was not considered clinically meaningful.
Dose Equivalence
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Paliperidone LAI 1-monthly:
- 50 mg = Risperidone oral 2 mg/day
- 75 mg = Risperidone oral 3 mg/day
- 100 mg = Risperidone oral 4 mg/day
- 150 mg = Risperidone oral 6 mg/day
-
Paliperidone LAI 3-monthly:
- 175 mg = Paliperidone LAI 1-monthly 50 mg
- 263 mg = Paliperidone LAI 1-monthly 75 mg
- 350 mg = Paliperidone LAI 1-monthly 100 mg
- 525 mg = Paliperidone LAI 1-monthly 150 mg
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Description
This quiz covers the essentials of Paliperidone Palmitate, a long-acting injection used in psychiatric treatment. It includes information on dosages, administration methods, and pharmacokinetics, crucial for healthcare professionals. Test your knowledge on this important medication and its clinical application.
