MH 701 SAFETY EXAM #2 Summer 20 Exam Questions And Answers MH 701 SAFETY EXAM #2 Summer 20 Exam Questions And Answers

MH 701 SAFETY EXAM #2 Summer 20 Exam Questions And Answers What differentiates SGAs from FGAs? - ANS SGAs have: D2 and 5HT2A receptor antagonism + Antidepressant action, treat pos and neg schizo sx, metabolic SE, D2D interactions, approved for schizophrenia, mania, and acute mania FGAs have positive symptom antipsychotic actions - EPS, hyperprolactinemia Mostly D2 receptor antagonism Which SGA has lowest EPS SE, but is associated with substantial risk of agranulocytosis? - ANS Clozapine The lower D2 receptor action is probably why clozapine does not cause EPS Weekly WBC counts are indicated to monitor the patient for development of agranulocytosis. What causes breast secretions while receiving perphenazine? Is this typical with both FGAs and SGAs? - ANS Perphenazine blocks dopamine 2 receptors in the pituitary, causing hyperprolactinemia, which can cause galactorrhea. Except for risperidone, SGAs do not elevate prolactin. Which of the SGAs is most likely and which is least likely to worsen a metabolic profile? - ANS Most likely: olanzapine -weight gain, metabolic risk Least likely: ziprasidone -weight neutral, lowers triglyceride levels Describe a cross taper from risperidone to olanzapine - ANS Taper the risperidone off over three weeks while simultaneously beginning olanzapine at 10 mg per day risperidone, quetiapine, and ziprazodone lack anticholinergic effects. Abrupt transition from a DRA, olanzapine, or clozapine to one of these agents may cause cholinergic rebound What are some monotherapy agents used as primary treatment of acute mania? - ANS "All of the SDAs (except clozapine) are FDA approved for this. Serotonin dopamine antagonist (SDAs) risperidone (Risperdal), and olanzapine (Zyprexa), ziprasidone (Geodon) Explain Serotonin Dopamine antagonist (SDA) - ANS The newer second-generation antipsychotic drugs, also called atypical antipsychotics are dopamine and 5HT2a antagonists. Down regulate both Dopamine and Serotonin receptors. SDAs include clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa). Which medications are FDA-approved for use in bipolar depression? - ANS quetiapine (Seroquel) is approved for bipolar depression. A fixed combination of olanzapine and fluoxetine known as Symbyax is approved as a treatment for acute bipolar depression, The FDA has added a new warning about which SGA, cautioning prescribers about potential QT interval prolongation when above-recommended doses of this drug are combined with which specific drugs? - ANS paliperidone (Invega) may cause an increase in QT interval and should be avoided in combination with other drugs that may cause QT interval prolongation. Effectiveness in treating symptom types in schizophrenia and schizoaffective disorder: DRAs compared to SDAs - ANS Positive symptoms: SDA = or DRA Negative & cognitive symptoms: SDA DRA The presumed antipsychotic effects of the SDAs are blockade of D2 dopamine receptors. How do the SDAs differ from older antipsychotic drugs? - ANS