BCPS Psychology Meds – Complete Study Guide
Schizophrenia Major Symptoms ✔️Ans - >2 for at least 1 month
Delusions*
Hallucinations
Disorganized speech
________
Grossly or disorganized symptoms
Negative symptoms
1A2 Substrates Schizo drugs ✔️Ans - Asenaphine, Clozapine,
Olanzapine, Ziprasidone
What enzyme does smoking affect ✔️Ans - 1A2 inducer
Adjust drugs when quits (adjust down) or starts (adjust up possibly)
2D6 Inhibs Schizo drugs ✔️Ans - Chlorpromazine
Fluphenazine
FGA QTc prolonging Drugs ✔️Ans - Chlorpromazine
Haloperidol
Thioridazine
SGA QTc prolonging drugs ✔️Ans - Clozapine
Ziprasidone
Iloperidone
Low Potency FGAs ✔️Ans - Chlorpromazine
Thioridazine
the doses are >50mg
Low Potency FGA SE's ✔️Ans - Sedation (histamine)
Anticholinergic
Orthostatic hypotension (alpha)
High Potency FGA's ✔️Ans - Fluphenazine
Haloperidol
, Thiothixene
Doses are between 2-5mg
Remember "potent"
Parkinsonism EPS ✔️Ans - Bradykinesia, Ridgity, tremor, akinesia
Dystonia (acute) EPS ✔️Ans - Torticollis, laryngospasm
Can treat with anti-chols
Akathisia EPS ✔️Ans - somatic restlessness
Tardive Dyskinesia EPS ✔️Ans - abnormal involuntary movements that
occur with long-term antipsychotic therapy
Neuroleptic Malignant Syndrome EPS ✔️Ans - Fever, tachycardia, labile
blood pressure, waning conciousness, agitation
TD EPS Drug management ✔️Ans - Switch to clozapine if significant as
it has no risk of TD
SGA Characteristics ✔️Ans - Risk of EPS is lower
Risk of TD is lower
Block serotonin-2 receptors
Treatment Resistent Schizo ✔️Ans - Clozapine = DOC
have to fail 2 therapies (one FGA and SGA (possibly 2 SGAs)
Clozapine Agranulocytosis ✔️Ans - Monitor weekly for 1st 6 months
Clozapine WBC cutoffs ✔️Ans - ANC > 1500 is goal
if ANC <1000, hold and re-start once >1500
if ANC <500, stop don't re-challenge
SGA's with EPS Risk (akathisia) ✔️Ans - Aripiprazole
Brexipiprazole
Cariprazine
Lurasidone
Asenaphine
Schizophrenia Major Symptoms ✔️Ans - >2 for at least 1 month
Delusions*
Hallucinations
Disorganized speech
________
Grossly or disorganized symptoms
Negative symptoms
1A2 Substrates Schizo drugs ✔️Ans - Asenaphine, Clozapine,
Olanzapine, Ziprasidone
What enzyme does smoking affect ✔️Ans - 1A2 inducer
Adjust drugs when quits (adjust down) or starts (adjust up possibly)
2D6 Inhibs Schizo drugs ✔️Ans - Chlorpromazine
Fluphenazine
FGA QTc prolonging Drugs ✔️Ans - Chlorpromazine
Haloperidol
Thioridazine
SGA QTc prolonging drugs ✔️Ans - Clozapine
Ziprasidone
Iloperidone
Low Potency FGAs ✔️Ans - Chlorpromazine
Thioridazine
the doses are >50mg
Low Potency FGA SE's ✔️Ans - Sedation (histamine)
Anticholinergic
Orthostatic hypotension (alpha)
High Potency FGA's ✔️Ans - Fluphenazine
Haloperidol
, Thiothixene
Doses are between 2-5mg
Remember "potent"
Parkinsonism EPS ✔️Ans - Bradykinesia, Ridgity, tremor, akinesia
Dystonia (acute) EPS ✔️Ans - Torticollis, laryngospasm
Can treat with anti-chols
Akathisia EPS ✔️Ans - somatic restlessness
Tardive Dyskinesia EPS ✔️Ans - abnormal involuntary movements that
occur with long-term antipsychotic therapy
Neuroleptic Malignant Syndrome EPS ✔️Ans - Fever, tachycardia, labile
blood pressure, waning conciousness, agitation
TD EPS Drug management ✔️Ans - Switch to clozapine if significant as
it has no risk of TD
SGA Characteristics ✔️Ans - Risk of EPS is lower
Risk of TD is lower
Block serotonin-2 receptors
Treatment Resistent Schizo ✔️Ans - Clozapine = DOC
have to fail 2 therapies (one FGA and SGA (possibly 2 SGAs)
Clozapine Agranulocytosis ✔️Ans - Monitor weekly for 1st 6 months
Clozapine WBC cutoffs ✔️Ans - ANC > 1500 is goal
if ANC <1000, hold and re-start once >1500
if ANC <500, stop don't re-challenge
SGA's with EPS Risk (akathisia) ✔️Ans - Aripiprazole
Brexipiprazole
Cariprazine
Lurasidone
Asenaphine
