Learning Objectives: 1.Describe the most common theories regarding the etiology of schizophrenia.2.Outline the neurotransmitters thought to be involved in schizophrenia.3.List the three categories of symptoms seen in schizophrenia and give examples of each.4.List the types of nonpharmacologic therapies that should be offered to individuals with schizophrenia.5.Discuss the major areas included in the initial evaluation of a patient suspected of having schizophrenia.6.Discuss the considerations for choosing initial drug therapy for a patient with schizophrenia.7.Recommend methods to improve treatment adherence in a patient with schizophrenia.8.Discuss treatment approaches for individuals with treatment-resistant schizophrenia.9.Discuss the potential advantages and disadvantages of antipsychotic polypharmacy.10.Discuss the two major hypotheses regarding second-generation antipsychotic mechanism of action, and give an example of a drug with each mechanistic approach.11.Compare the side effect profiles of antipsychotics, and apply this information to the selection of an appropriate antipsychotic regimen for an individual patient.12.Recommend a treatment plan for a patient with Parkinson’s symptoms secondary to a first-generation antipsychotic, secondary to a second-generation antipsychotic.13.Evaluate a patient profile of a patient with schizophrenia and co-occurring general medical disorders for potential drug interactions.14.Outline a pharmacotherapeutic treatment plan for a patient with schizophrenia in acute exacerbation, including appropriate monitoring and follow-up. Required Readings: Crimson ML, Smith T, Buckley PF. Chapter 84: Schizophrenia. In: Pharmacotherapy: A Pathophysiologic Approach. Dipiro et al., eds. 11 th PERTINENT AGENTS Psychosis/Schizophrenia Pharmacotherapeutics IV Spring 2020 Abbey Krysiak, PharmD, BCPP Office phone: (814) 860-5113 [email protected] FIRST GENERATION AGENTS Chlorpromazine (Thorazine) Thioridazine (Mellaril) Fluphenazine (Prolixin, decanoate) Perphenazine (Trilafon) Thiothixene(Navane) Trifluperazine (Stelazine) Loxapine (Loxitane, Adasuve Inhaled Powder) Molindone (Moban) Haloperidol (Haldol, Haldol-D) SECOND GENERATION AGENTS Aripiprazole (Abilify, Abilify Maintena, Abilify Aristada, MyCite) Clozapine (Clozaril) Olanzapine (Zyprexa, Zydis, Relprevv) Quetiapine (Seroquel) Asenapine (Saphris) Risperidone (Risperdal, Risperdal Consta) Ziprasidone (Geodon) Iloperidone (Fanapt) Paliperidone (Invega, Invega Sustenna, Invega Trinza) Lurasidone (Latuda) Brexpiprazole (Rexulti) – 2015 Cariprazine (Vraylar) – 2015 Pimavanserin (Nuplazid) -
AKrysiak || Schizophrenia || Spring 2020 INTRODUCTION One of the most complex and challenging psychiatric disorders Psychotic disorders are marked by: o Deterioration in social functioning o Loss of reality and perceptual deficits (including delusions and hallucinations) o Affective or mood instability Psychoses: o Group of symptoms, NOT a diagnosis, and NOT necessarily dangerous Schizophrenia is a thought
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