CMN 548 Module 5 Psychopharmacology
(Latest )100% Correct
Questions & Answers
What is the likely underlying cause of Tardive Dyskinesia? - Correct answer Increased
sensitivity of dopamine receptors in the basal ganglia.
Should dopamine blockers be increased to reduce tardive dyskinesia sympptoms? -
Correct answer Only if the movements are severe and incapacitating.
- The disorder is most often not progressive and can improve in most patients.
- Can be switched to dopamine-serotonin antagonists such as clozapine
What are withdrawal emergent dyskinesias? - Correct answer If patients have their
dosages of antipsychotic medication either decreased or discontinued, abnormal
movements may worsen temporarily or appear for the first time and then diminish.
Which patient populations are at highest risk for tardive dyskinesia? - Correct answer
- Older women
- Patients with affective disorders
,- 10-20% incidence in treatment >1 year
How often should patients receiving dopamine blockers be evaluated for tardive
dyskinesia? - Correct answer Every 6 months
- Can evaluate severity using the Abnormal Involuntary Movements Scale (AIMS)
Why does clozapine (Clozaril, DSA antipsychotic) have a lower risk of tardive
dyskinesia? - Correct answer It does not result in the increased sensitivity of striatal
D2 receptors, which is associated with typical neuroleptics and has been theorized to
result in TD.
What is the mechanism of action of the two medications approved for treatment of
Tardive Dyskinesia? - Correct answer VMAT2 inhibitors
- Can be given in conjunction with antipsychotics
What medication is contraindicaated in the treatment of antipsychotic induced
hypotension? - Correct answer Epinephrine
- due to beta stimulation it worsens hypotension
,What is the only dopamine serotonin antagonist (DSA) that is more effective than other
antipsychotics at improving overall symptoms? - Correct answer Clozapine (Clozaril)
- This is why antipsychotics are typically chosen based on side effect profile
Olanzapine (Zyprexa, DSA antipsychotic) causes what side effects in children? -
Correct answer - Somnolence
- Liver enzyme elevation
- Prolactin elevation
- Weight gain
*Due to these effects it should be used only when other antipsychotics have failed
Olanzipine (Zyprexa, DSA antipsychotic) has what effect of liver enzymes? - Correct
answer Increases ALT to 3 times the upper limit of normal in 2% of cases
Which medication in the DSA antipsychotic family has a low liability for metabolic side
effects? - Correct answer Lurasidone (Latuda)
- take with food
, - potent antagonist at 5-HT2A, D2, and 5-HT7 receptors and a partial agonist at the 5-
HT1A receptor.
- Side effects include sedation, EPS, nausea
Lurasidone (Latuda, DSA antipsychotic) is FDA approved for the treatment of what? -
Correct answer - Schizophrenia in adults
- Adults with bipolar depression as a monotherapy or adjunct to lithium or valproate
Which DSA antipsychotic does not cause EPS, but is associated with significant
hematologic toxicity? - Correct answer Clozapine (Clozaril)
- Agranulocytosis
- Reversible when drug is stopped
- Propranolol increases risk of agranulocytosis
Clozapine (Clozaril) is indicated for patients with which psychiatric diagnosis who are
treatment resistant or unable to tolerate side effects? - Correct answer Schizophrenia
- Clozapine (Clozaril, DSA antipsychotic)
- Minimal EPS side effects or tardive dyskinesia
(Latest )100% Correct
Questions & Answers
What is the likely underlying cause of Tardive Dyskinesia? - Correct answer Increased
sensitivity of dopamine receptors in the basal ganglia.
Should dopamine blockers be increased to reduce tardive dyskinesia sympptoms? -
Correct answer Only if the movements are severe and incapacitating.
- The disorder is most often not progressive and can improve in most patients.
- Can be switched to dopamine-serotonin antagonists such as clozapine
What are withdrawal emergent dyskinesias? - Correct answer If patients have their
dosages of antipsychotic medication either decreased or discontinued, abnormal
movements may worsen temporarily or appear for the first time and then diminish.
Which patient populations are at highest risk for tardive dyskinesia? - Correct answer
- Older women
- Patients with affective disorders
,- 10-20% incidence in treatment >1 year
How often should patients receiving dopamine blockers be evaluated for tardive
dyskinesia? - Correct answer Every 6 months
- Can evaluate severity using the Abnormal Involuntary Movements Scale (AIMS)
Why does clozapine (Clozaril, DSA antipsychotic) have a lower risk of tardive
dyskinesia? - Correct answer It does not result in the increased sensitivity of striatal
D2 receptors, which is associated with typical neuroleptics and has been theorized to
result in TD.
What is the mechanism of action of the two medications approved for treatment of
Tardive Dyskinesia? - Correct answer VMAT2 inhibitors
- Can be given in conjunction with antipsychotics
What medication is contraindicaated in the treatment of antipsychotic induced
hypotension? - Correct answer Epinephrine
- due to beta stimulation it worsens hypotension
,What is the only dopamine serotonin antagonist (DSA) that is more effective than other
antipsychotics at improving overall symptoms? - Correct answer Clozapine (Clozaril)
- This is why antipsychotics are typically chosen based on side effect profile
Olanzapine (Zyprexa, DSA antipsychotic) causes what side effects in children? -
Correct answer - Somnolence
- Liver enzyme elevation
- Prolactin elevation
- Weight gain
*Due to these effects it should be used only when other antipsychotics have failed
Olanzipine (Zyprexa, DSA antipsychotic) has what effect of liver enzymes? - Correct
answer Increases ALT to 3 times the upper limit of normal in 2% of cases
Which medication in the DSA antipsychotic family has a low liability for metabolic side
effects? - Correct answer Lurasidone (Latuda)
- take with food
, - potent antagonist at 5-HT2A, D2, and 5-HT7 receptors and a partial agonist at the 5-
HT1A receptor.
- Side effects include sedation, EPS, nausea
Lurasidone (Latuda, DSA antipsychotic) is FDA approved for the treatment of what? -
Correct answer - Schizophrenia in adults
- Adults with bipolar depression as a monotherapy or adjunct to lithium or valproate
Which DSA antipsychotic does not cause EPS, but is associated with significant
hematologic toxicity? - Correct answer Clozapine (Clozaril)
- Agranulocytosis
- Reversible when drug is stopped
- Propranolol increases risk of agranulocytosis
Clozapine (Clozaril) is indicated for patients with which psychiatric diagnosis who are
treatment resistant or unable to tolerate side effects? - Correct answer Schizophrenia
- Clozapine (Clozaril, DSA antipsychotic)
- Minimal EPS side effects or tardive dyskinesia
