Benefits of Long-Acting Injectables and Treatment for Acute Agitation

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46 Questions

In schizophrenia, the mesolimbic system shows an increase in dopamine, resulting in _______ symptoms.

positive

The mesocortical pathway in schizophrenia exhibits dopamine hypoactivity, leading to ______, ______, and ______ symptoms.

negative; cognitive; affective

The Nigrostriatal pathway experiences a decrease in dopamine and is associated with EPS (extrapyramidal side effects) and TD (tardive dyskinesia) drug side effects due to ________ in DA.

decrease

In schizophrenia, the Tuberoinfundibular pathway demonstrates a decrease in dopamine, contributing to its ________.

decrease

Risperidone requires dose adjustments for hepatic and ______ impairment

renal

Risperidone DDI with ______?

CYP2D6

Risperidone warning for QTc ______

prolongation

Ziprasidone dosing and formulations? -twice a day -oral capsule, IM injection ______

(immediate)

Which drug must you eat at least a 500 kcal meal to work? ______

ziprasidone

Pimavanserine MOA? Inverse agonist and antagonist at 5-ht2a and 5-ht2c ______

receptors

Clozapine is recommended to be offered after other options failed or persistent ________ or serious aggression or hostility.

suicidality

Dose titration is required in ________.

clozapine

ANC formula: ANC = Total WBC count × (ABS neutrophils + ABS bands) X ________.

1000

Iloperidone is not recommended in severe ________ dysfunction.

hepatic

Lurasidone must be taken with a ________ kcal meal to improve bioavailability.

350

Zyprexa relprevv has a black box warning for post injection delirium/sedation syndrome and facilities must have emergency response services readily available and continuous monitoring must be done ________ hours after dose.

3

Olanzapine/samidorphan mechanism: u-opioid receptor antagonist - thought to help minimize weight gain associated with ________.

olanzapine

Quetiapine is commonly used in ICU delirium and ________ disorders.

sleep

Typical antipsychotics primarily act as dopamine _________

antagonists

When taking Quetiapine XR, it can be taken with or without ________.

food

Atypical antipsychotics primarily act as dopamine and _________ antagonists

serotonin

Paliperidone is contraindicated in hypersensitivity to ________.

risperidone

Quetiapine warnings and precautions include QTc prolongation and suicidal thoughts in ________.

children

It is recommended to optimize treatment with how many agents? _________

one

NMS symptoms include rigidity, hyperthermia, autonomic dysfunction, and altered _________ status

mental

Risperidone is available in oral tablet, ODT, SUBQ and ________ injection formulations.

IM

NMS occurs at _________ point in treatment

any

Extrapyramidal symptoms include akathisia, dystonia, pseudo-parkinsonism, and tardive _________

dyskinesia

Akathisia presentation includes anxiety, restlessness, and irresistible urge to _________

move

Dystonia presentation includes sustained skeletal muscle contraction and _________

rigidity

Pseudo-parkinsonism presentation includes rigidity, tremor, bradykinesia, and shuffled _________

gait

Tardive dyskinesia presentation includes rhythmic involuntary _________

movements

VMAT2 inhibitors include deutetrabenazine and _________

valbenazine

Hyperprolactinemia short-term effects include menstrual disturbances, sexual dysfunction, and _________

gynecomastia

Benefits to LAIs include a significant reduced risk for psychiatric hospitalizations, any hospitalization, ER visits, risk of death by any cause, and suicide attempts. LAIs are helpful in cases of difficulty with ________.

adherence

The first line for acute agitation and aggression involves non-pharmacologic interventions and de-escalation techniques, while the second line includes ______ interventions.

pharmacologic

For acute agitation and aggression, oral antipsychotic options include haloperidol, aripiprazole, asenapine, risperidone, and ________.

olanzapine

Non-oral antipsychotics used for acute agitation and aggression may include haloperidol, droperidol, loxapine, olanzapine, and ________.

ziprasidone

The formulation options for acute agitation and aggression from best to worst are PO > IM >> ______.

IV

Haloperidol Decanoate is a long-acting injection given every ______ weeks.

4

Haloperidol decanoate maintenance is usually 10X the oral dose and may require oral ______.

overlap

Fluphenazine Deconate is a long-acting injection given every ______ weeks.

two

Fluphenazine decanoate has a short onset of action and oral overlap is ______ necessary.

not

Psychiatric hospitals must assess BMI, BP, blood glucose control, and lipid status within the past ______ for patients discharged with a prescription for an antipsychotic drug.

year

Aripiprazole's MOA involves dopamine and serotonin ______ agonist.

partial

Aripiprazole benefits include low risk of metabolic abnormalities, sexual dysfunction, and can decrease ______ levels.

prolactin

Learn about the benefits of Long-Acting Injectables (LAIs) for individuals struggling with adherence to medication. Explore the first-line and second-line treatment options for acute agitation and aggression, including non-pharmacological interventions and pharmacological choices.

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