VERIFIED 16, MARYVILLE 663 EXAM 3 QUESTIONS AND
ANSWERS
lurasidone (latuda)
FDA- schizophrenia 13+, BPD
****Take with food 350kcal
1/2 life 18-31hr
DOSE- 40-80mg
hits D2 & 5HT 2A,&,1A
SE dose dependant-sedation, akathesia,wt gain,DM
**no QT issues***
CYP 3A4
Co-admin with strong 3A4 inhibitor (Luvox etc.) or inducer (rifampin) is Contraindicated
antipsychotic BBW
BBW: Increased risk of death and CV events in elderly pts w/ dementia related
psychosis
paliperidone (invega)
FDA: schizophrenia, schizoaffective d/o
take with food Absorption is reduced if taken on an empty stomach
D2, 5HT 1A & 7
*Dose-dependent EPS
*Hyperprolactinemia
*increase risk for DM/dyslipidemia
*******(Wt gain/Sedation common)*****
DOSE- 6mg/day in am
Increase by 3mg/day every 5 days
Max: 12 mg/day
, Dose ranges:
Sustenna: 39-234mg/mo
Trinza: 273-819mg/3 mo
Sedation, hypersalivation, dose-dependent orthostatic hypotension, tachycardia
QT prolongation
when to stop an antipsychotic
ANC <1000
non psych meds that prolong QT
pimozide, thioridazine, selected antiarrhythmics, moxifloxacin, sparfloxacin
Ziprasidone (Geodon)
FDA: Schizophrenia, acute agitation in schizophrenia, acute mania/mixed mania,
BP maintenance
Metabolized by CYP450 3A4 (absorption is approximately doubled if taken with
food)
1/2 life 6.6hr
*stimulating at low doses-raise dose
*sedating at high doses-lower dose
Dose 20 mg BID, but 40mg BID or 60 mg BID may be better tolerated; max: 100mg BID
minimal CYP interaction
special labs EKG/CMP (K+, Mg+)
labs for all antipsychotics
Weight, BMI, waist circumference, BP, fasting glucose/lipid profile, and fasting
triglycerides, CBC
fluphenazine (prolixin)
FDA Psychotic disorders
Bipolar disorder
Strong D2
Dose Oral: 1–20 mg/day
Intramuscular: generally 1/3 to 1/2 the oral dose
Decanoate for intramuscular or subcutaneous administration: 12.5 mg–100 mg/2 weeks
(maintenance)
ANSWERS
lurasidone (latuda)
FDA- schizophrenia 13+, BPD
****Take with food 350kcal
1/2 life 18-31hr
DOSE- 40-80mg
hits D2 & 5HT 2A,&,1A
SE dose dependant-sedation, akathesia,wt gain,DM
**no QT issues***
CYP 3A4
Co-admin with strong 3A4 inhibitor (Luvox etc.) or inducer (rifampin) is Contraindicated
antipsychotic BBW
BBW: Increased risk of death and CV events in elderly pts w/ dementia related
psychosis
paliperidone (invega)
FDA: schizophrenia, schizoaffective d/o
take with food Absorption is reduced if taken on an empty stomach
D2, 5HT 1A & 7
*Dose-dependent EPS
*Hyperprolactinemia
*increase risk for DM/dyslipidemia
*******(Wt gain/Sedation common)*****
DOSE- 6mg/day in am
Increase by 3mg/day every 5 days
Max: 12 mg/day
, Dose ranges:
Sustenna: 39-234mg/mo
Trinza: 273-819mg/3 mo
Sedation, hypersalivation, dose-dependent orthostatic hypotension, tachycardia
QT prolongation
when to stop an antipsychotic
ANC <1000
non psych meds that prolong QT
pimozide, thioridazine, selected antiarrhythmics, moxifloxacin, sparfloxacin
Ziprasidone (Geodon)
FDA: Schizophrenia, acute agitation in schizophrenia, acute mania/mixed mania,
BP maintenance
Metabolized by CYP450 3A4 (absorption is approximately doubled if taken with
food)
1/2 life 6.6hr
*stimulating at low doses-raise dose
*sedating at high doses-lower dose
Dose 20 mg BID, but 40mg BID or 60 mg BID may be better tolerated; max: 100mg BID
minimal CYP interaction
special labs EKG/CMP (K+, Mg+)
labs for all antipsychotics
Weight, BMI, waist circumference, BP, fasting glucose/lipid profile, and fasting
triglycerides, CBC
fluphenazine (prolixin)
FDA Psychotic disorders
Bipolar disorder
Strong D2
Dose Oral: 1–20 mg/day
Intramuscular: generally 1/3 to 1/2 the oral dose
Decanoate for intramuscular or subcutaneous administration: 12.5 mg–100 mg/2 weeks
(maintenance)
