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Indications for olanzapine?
bipolar - adjunct to valproate or lithium
Precautions of antipsychotics?
parkinsons - may worsen symptoms (consider clozapine instead)
Epilepsy - may lower seizure threshold
Prolonged QT interval - may cause arrhythmias
Adverse effects of antipsycotics?
sedation, anxiety, agitation, anticholinergic effects.
SIAHD, anaemia, thrombocytopaenia
Which antipsychotics have an increased risk of diabetes through increase blood glucose levels?
What else do they increase the risk of?
Clozapine and olanzapine, (quietapine?)
Dyslipidaemia and weight gain
Which antipsychotic causes skin reactions?
Which antipsychotics can increase the risk of stroke when used in patients with dementia?
arirprazole, olanzapine, risperidone.
Dose of olanzapine?
10mg once daily, increase by 2.5mg to 20mg
Counselling for olanzapine
Tell your doctor if you stop smoking since your dose may need adjusting
Take medication regularly, even if you fele better
Avoid illicit substances
You may feel dizzy on standing, get up slowly.
Indications for quietapine?
Adjunct in refractory depression
Generalized anxiety disorder
dosage of quietapine?
25mg twice daily (upto 200-400mg twice daily) - skitz
50mg twice daily to 200mg twice daily (upto 800mg daily) for bipolar
Dose of risperidone?
1mg twice daily increasing upto 4-6mg daily (0.5mg daily if elderly or renally impaired)
Indications of lithium?
- Prevention of manic or depressive episodes in bipolar disorder
- Treatment of acute mania
- Schizoaffective disorder and chronic schizophrenia
Precautions of lithium?
- Hyponatremia - increased lithium toxicity
- psoriasis - can exacerbate
- Treatment with drugs that can cause serotonin toxicity
- Renal impairment
Adverse effects of lithium?
metallic taste, nausea, diarrhoea, weight gain, fatigue, headache, vertigo, tremor, psoriasis,
Dose of lithium?
- acute mania: 750-1000mg daily in divided dose with food. max dose is 2500 daily
- 250-1000mg in divided daily doses for prophylaxis
Counselling for lithium?
- Regular blood tests (renal and thyroid function)
- Be alert for signs and symptoms of lithium toxicity (eg extreme thirst and frequent urination, nausea and vomiting), especially during illness, excessive sweating or low fluid intake; if these occur, stop taking the
- tablets and seek medical attention immediately.
- avoid taking with hot drinks.
- Maintain a normal diet with regular salt and fluid intake.
- Drink more fluid during hot weather to avoid toxicity.
- Avoid sodium bicarbonate (found in products such as indigestion medicines, eg Salvital®, and products like Ural®, Citralite® or Citravescent®) as it makes lithium less effective.