Psychiatric Disorders' Materials for DSM II

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mcucullu
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160656
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Psychiatric Disorders' Materials for DSM II
Updated:
2012-07-01 15:50:11
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disease state management II dsm psychiatric disorders schizophrenia drugs
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This set includes the materials covering schizophrenia including, drugs, doses, treatments, etc.
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  1. In what areas are there a disruption in patients with schizophrenia?
    • 1) perception
    • 2) emotion
    • 3) cognition 
  2. What are the different classifications of schizophrenia?
    • 1) disorganized
    • 2) catatonic
    • 3) paranoid
    • 4) undifferentiated
    • 5) residual 
  3. List some positive symptoms.
    • 1) hallucinations
    • 2) delusions 
  4. List some negative symptoms.
    • 1) flat affect
    • 2) poverty of thought
    • 3) avolition
    • 4) anhedonia 
  5. What criteria must be met before being able to diagnose a patient with schizophrenia?
    • Two or more of the following symptoms for at least one month:
    • 1) hallucinations
    • 2) delusions
    • 3) disorganized speech
    • 4) grossly disorganized or catatonic behavior
    • 5) negative symptoms, anhedonia, flat affect, avolition
    • 6) significant social dysfunction (signs must persist for at least six months)
    • 7) mental retardation, schizoaffective disorders, mood disorders, substance abuse, and other causative medical disorders have been ruled out 
  6. Which agent is the only one proven to be effective in the treatment of refractory schizophrenia?
    clozapine (Clozaril, FazaClo)
  7. What are some atypical antipsychotics used in the treatment of schizophrenia?
    • 1) clozapine (Clozaril)
    • 2) respiradone (Risperdal)
    • 3) olanzepine (Zyprexa)
    • 4) quetiapine (Seroquel)
    • 5) ziprasidone (Geodon)
    • 6) Arpripazole (Abilify)
    • 7) Paliperidone (Invega) 
  8. Which atypical antipsychotic is the only one approved in the treatment of schizophrenia in patients ages 13-17?
    risperidone (Risperdal)
  9. What are some side effects associated with typical antipsychotics?
    • 1) sedation
    • 2) orthostatic hypotension 
  10. What are some side effects associated with atypical antipsychotics?
    • 1) weight gain
    • 2) anticholinergic side effects
    • 3) EPS
    •   a. dystonic reactions
    • 4) akathisia
    • 5) psuedo-parkinsonism
    • 6) irreversible drug-induced movement disorders
    • 7) choreoathetosis
    • 8) oral/buccal movements
    • 9) NMS
    • 10) endocrine/metabolic effects
    •   a. amenorrhea
    •   b. galactorrhea
    •   c. gynaecomastia
    •   d. hyperprolactinemia
    •   e. decreased glucose tolerance 
    • 11) dermatologic
    •   a. photosensitivity
    •   b. allergic
    •   c. pigmentation problems
    • 12) temperature disregulation
    • 13) QT prolongation
    • 14) opthalmologic effects
    •   a. pigmentary retinopathy associated with thioridazine at doses > 800 mg.
    •   b. melanin deposits on cornea possibly leading to blindness 
  11. What are some treatments given for patients experiencing dystonia of EPS as an adverse effect?
    • 1) benztropine (Cogentin) 1-2 mg IM
    • 2) diphenhydramine (Benadryl) 25-50 mg q 30 minutes until relieved
  12. What are some treatments given for patients experiencing akathisia associated with atypical antipsychotics?
    • 1) benzodiazepines
    • 2) lipophilic beta blockers
    •   a. propanolol
    • 3) clonidine
    • 4) anticholinergics
  13. What are some treatments give for patients experiencing pseudo-parkinsonism associated with atypical antipsychotics?
    • 1) amantadine (Symmetrel) 100 mg BID
    • 2) anticholinergics
  14. What are some strategies that can be incorporated for patients on an atypical antipsychotics to prevent adverse effects?
    • 1) lowest effective dose
    • 2) vitamin E
    • 3) vitamin B6
    • 4) lecithin 
    • 5) monitor by adminstering AIMS
  15. What are some symptoms of NMS?
    • 1) BT > 104o F
    • 2) lead-pipe rigidity
    • 3) HTN
    • 4) diaphoresis (sweating)
    • 5) increased HR 
    • 6) incontinence
    • 7) increased LFTs
    • 8) increased CPK
    • 9) increased WBCs
  16. How would you treat patients with NMS?
    • 1) d/c atypical antipsychotic
    • 2) hydrate patient
    • 3) cooling blankets
    • 4) bromocriptine
    • 5) dantrolene sodium
  17. What are some treatments for acute schizophrenia?
    • 1) haloperidol (Haldol-D) 5-10 mg IM/fluphenazine (Prolixin-D)  5-10 mg IM and
    •  lorazepam (Ativan) 2 mg IM q 4 hrs and anticholinergics 
    • 2) olanzepine  (Zyprexa) 10 mg IM
    •   a. second dose in 2 hrs
    •   b. third dose in another 4 hrs
    •   c. maximum dose: 30 mg QD
    • 3) ziprasidone (Geodon) 10 mg IM q 2 hrs or 20 mg IM q 4 hrs
    •   a. maximum dose: 40 mg QD
  18. What parameters must be monitored in patients taking atypical antipsychotics?
    • 1) fasting blood glucose 
    •   a. baseline
    •   b. after 12 weeks
    • 2) lipids
    •   a. baseline
    •   b. after 12 weeks
    • 3) BMI
    •   a. 4 weeks
    •   b. 8 weeks
    •   c. 12 weeks
    •   d. quarterly
    • 4) waist circumference
    •   a. baseline
    •   b. annually
  19. What are two alternative drugs that can be used in patients who are non-compiant to PO dosing?
    • 1) haloperidol decanoate (Haldol-D)
    • 2) fluphenazine decanoate (Prolixin-D) 
  20. How is the dosing converted for a patient who was taking haloperidol PO to Haldol-D?
    PO daily dose x 10 equals the IM dose every 4 weeks
  21. How is the dosing converted for a patient who was taking fluphenazine PO to Prolixin-D?
    1 mg po = 1.25 mg IM every 2 weeks
  22. What is contraindicated in the use of the depot forms of fluphenazine and haloperidol?
    allergies to sesame seed oil
  23. How is fluphenazine and haloperidol administered?
    IM into the gluteal or deltoid muscle with a 16 or 18 gauge needle
  24. How is the long-acting injection form of respiridone (Risperdal Consta) administered?
    It is administered with a 3 week overlap of risperidone (Risperdal) PO.

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