Psychopharmacologic Approaches to Treatment of Psychopathology exam questions and answers fully solved

Psychopharmacologic Approaches to Treatment of Psychopathology exam questions and answers fully solved What are the brand names, FDA-approved indications, and one off-label use for clozapine? - AnswersBrand names: Clozaril, Leponex, Fazaclo, Versacloz. FDA-approved: Treatment-resistant schizophrenia, reducing suicidal behavior in schizophrenia/schizoaffective disorder. Off-label: Calming psychosis in Parkinson's disease (Wong et al., 2022). What class of medication is clozapine? - AnswersAtypical (second-generation) antipsychotic (Stahl, 2021). How does clozapine work to reduce extrapyramidal symptoms (EPS)? - AnswersAntagonizes dopamine (D2) and serotonin (5-HT2A) receptors with lower D2 affinity, reducing EPS (Stahl, 2021). What is the absorption, metabolism, and half-life of clozapine? - Answersbsorption: 90% oral bioavailability, peak in 2.5 hours. Metabolism: Hepatic via CYP1A2 (major), CYP3A4, CYP2D6. Half-life: 12 hours (8-16 hours) (Stahl, 2021). How does clozapine affect schizophrenia symptoms and suicidal behavior? - AnswersBalances dopamine-serotonin to reduce positive (hallucinations) and negative (apathy) symptoms; serotonin modulation reduces suicidal behavior. What is the starting dose, target dose, and one dosing alteration for clozapine? - AnswersStart: 12.5 mg once/twice daily. Target: 300-450 mg/day (clozapine, n.d.). Alteration: Reduce dose with hepatic impairment. What is a dosing consideration for elderly patients using clozapine? - AnswersStart "low and slow" at 6.25-12.5 mg/day; monitor for hypotension and seizures (clozapine, n.d.). Name three common and one serious side effect of clozapine - AnswersSedation, weight gain, hypersalivation. Serious: Agranulocytosis (1-2% risk) (Stahl, 2021). Why is clozapine effective for tardive dyskinesia (TD)? - AnswersLow D2 receptor blockade reduces TD risk and makes it effective for TD treatment (Wong et al., 2022). What is one absolute contraindication and one drug interaction for clozapine? - AnswersAbsolute: History of clozapine-induced agranulocytosis. Interaction: CYP1A2 inhibitors (e.g., citalopram) increase clozapine levels What are two symptoms and one management step for clozapine overdose? - AnswersSymptoms: Delirium, seizures. Management: Supportive care What is the monitoring schedule for ANC with clozapine? - AnswersWeekly for first 6 months, biweekly for next 6 months, then monthly What changed about clozapine's REMS program on February 24, 2025? - AnswersFDA eliminated mandatory REMS for prescribers and pharmacies, improving access (Kameg, 2025). What should patients do if they experience fever or sore throat while taking clozapine? - AnswersTell their doctor immediately, as it may indicate agranulocytosis (Center for Drug Evaluation and Research, n.d.).