CMN 548 Module 5 Psychopharmacology Actual
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Psychopharmacology Practice Exam /CMN 548
Module 5 Psychopharmacology Exam Preparation
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Should dopamine blockers be increased to reduce tardive dyskinesia
symptoms? - 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? - 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? -
ANSWER-- Older women
- Patients with affective disorders
- 10-20% incidence in treatment >1 year
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How often should patients receiving dopamine blockers be evaluated for
tardive dyskinesia? - 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? - 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? - ANSWER-VMAT2 inhibitors
- Can be given in conjunction with antipsychotics
What medication is contraindicaated in the treatment of antipsychotic
induced hypotension? - 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? -
ANSWER-Clozapine (Clozaril)
- This is why antipsychotics are typically chosen based on side effect
profile
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Olanzapine (Zyprexa, DSA antipsychotic) causes what side effects in
children? - 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? - 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? - 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? - ANSWER-- Schizophrenia in adults
- Adults with bipolar depression as a monotherapy or adjunct to lithium
or valproate