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NSG 552 Psychopharmacology – Questions With Correct Solutions
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NSG 552 Psychopharmacology – Questions With Correct Solutions
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NSG 552 Psychopharmacology – Questions WithCorrect Solutions
What is the difference between typical and atypical antipsychotics w/r to the
receptors they block? Right Ans - first gen/typical= block D2 receptors
second/atypical= block D2 and serotonin (2A) receptors
What side effects do we see with low-potency typical antipsychotics? Right
Ans - - more *antiHistaminic [sedation, weight gain], antiAndrinergic
[hypotension], and antiMuscarinic [dry mouth, blurry vision, urinary
retention, constipation] ("HAM")* side effects compared to high potency
typical antipsychotics
but lower inidence of EPS and NMS
- more leathality in overdose due to *QTc prolongation* and potential for
heart block/ventricular tachycardia
- rare risk of agranulocytosis and slightly *higher seizure risk* than high
potency antipsychotics
What are examples of low-potency typical antipsychotics? Right Ans -
chlorpromazine (thorazine)
thioridazine (mellaril)
What are examples of midpotency typical antipsychotics? Right Ans -
loxapine (loxitane)- metabolite is an antidepressant
thiothixene (navane)
molindone (moban)
perphenazine (trilafon)
What are examples of high potency typical antipsychotics? Right Ans -
haloperiodol (haldol)
fluphenazine (prolixin)
trifuluoperazine (stelazine)
pimozide (orap)
What is the specific side effect of loxapine? Right Ans - loxapine (loxitane)
= midpotency first generation antipsychotic
higher risk of seizures
,What are specific side effects of chlorpromazine? Right Ans -
chlorpromazine (thorazine)= low potency first generation typical
antipsychotic
Commonly orthostatic hypotension
blue-gray skin discoloration
corneal deposits
photosensitivity
*used to treat nausea and vomiting, as well as intractable hiccups*
What are specific side effects of thioridazine (mellaril)? Right Ans -
associated w/ retinitis pigmentosa
What else is trifluoperazine (stelazine) approved for? Right Ans - use for
nonpsychotic anxiety
What are specific methods of delivery of haloperidol and what is its long
acting form? Right Ans - PO/IM/IV
long acting form available
*note: high potency antipsychotics are often given as intramuscular injection
to tx acute agitation or psychosis*
Long acting form is available for which two high potency typical
antipsychotics? why is this useful? Right Ans - haloperidol
fluphenazine (prolixin)
Good for patients who don't take their meds regularly!
What side effects do we see with high-potency typical antipsychotics? Right
Ans - EPS - hours to days
- Parkinsonism
- Akathisia
- Dystonia
*Reversible* with benztropine ("Cogentin"; anticholinergic agent)
Tardive dyskinesia (choreoathetoid movements of mouth and tongue) - years
*Irreversible*
, Hyperprolactinemia - MAY ALSO BE CAUSED BY RISPERIDONE
Neuroleptic malignant syndrome Right Ans - *fever*, autonomic instability,
leukocytosis, tachycardia, tremor, elevated CPK, *rigidity ("lead pipe")*,
excessive sweating, delirium ("FALTERED); treatment = supportive,
dantroline/ bromocriptine/ amantadine; note that one episode increases risk
of future episodes
CYP450 inducers Right Ans - *Carbamazepine*
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
St. John's wort/ Sulfonylyreas
Tobacco
(CRAP GPS)
CYP450 inhibitors Right Ans - Bactrim
Grapefruit juice
Sodium valproate (*Valproic acid*)
Isoniazid
Cimetedine
Ketoconazoles
Fluconazole
Alcohol
Chloramphenicol
Erythromycin
SSRIs:
- Fluvoxamine
- Fluoxetine
- Paroxetine
- Duloxetine
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