Treating Schizophrenia
Next EPS
Name that Drug!
100
Along with non-pharmacological interventions, this class of meds should be used for psychosis
What are antipsychotics?
*Hospitalize if this is their first psychotic event or if there is risk of harm to anyone
100
Choreic movements, repetitive lip smacking or chewing are all signs of this EPS
What is tardive dyskinesia?
100
This is the direct precursor to dopamine which can be used to treat drug-induced parkinsonism
What is levodopa or L-DOPA?
*Levodopa can cross the BBB unlike dopamine, so the precursor is used for that reason!
200
You [should/should not] stop using antipsychotics for a pregnant patient with schizophrenia
What is should not?
*Preferably older generations like haloperidol (1st) or olanzapine (2nd) but stopping risks relapse!
200
Restlessness as a movement disorder is known as this
What is akathisia?
*You feel like you can't stand or sit still
200
Clonidine, benzodiazepines, or this class of drug (mainly propanolol) can treat akathisia
What are beta blockers?
*Block both beta-1 and beta-2; try to avoid if patient has chronic asthma/COPD or insulin-dependent diabetes
300
If after 6 weeks at least two antipsychotics failed to treat positive schizophrenia symptoms, use this specific antipsychotic
What is clozapine?
*Never use this first due to seizure and agranulocytosis AEs
300
Torticollis, oculogyric crisis, and laryngospasm are all examples of this extrapyramidal symptom that can be caused by antipsychotics
What is acute dystonia?
*Painful and hour-day long muscle spasms
300
Either of these drug classes CNS muscarinic receptors to treat acute dystonia
What are anticholinergics OR antihistamines (need just one)?
*Both can block the muscarinic receptor and have side effects of dry mouth and sedation
400
This type of therapy can be used to improve cognitive impairments in a patient with schizophrenia
What is cognitive remediation therapy?
*Mental exercises to improve cognitive ability; often paired with social skills training to break down complex interactions
400
One symptom of pseudoparkinsonism is this, where a person's limb will move in short, jerky motions rather than smooth motion
What is cogwheel rigidity?
*May also experience bradykinesia
400
For drug-induced/pseudoparkinsonism, this drug which blocks NMDA receptors can be used
What is amantidine?
*Blocking the receptors releases more DA and prevents reuptake, but watch out for livedo reticularis
500
If the antipsychotic works, you should prescribe the drug for this amount of time
What is forever/indefinitely?
*A psychiatrist should determine if a long-term drug should be use, but generally you can base it from patient preference for injections/adherence
500
Extrapyramidal symptoms from antipsychotics will occur because this specific receptor is antagonized
What is D2 receptor?
*Specifically along nigrostriatal pathways
500
These two antipsychotics are the least likely to lead to drug-induced parkinsonism
What are quetiapine and clozapine?
*They are both atypical antipsychotics, but be careful with clozapine!