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% Document Info
\author{Stormes RN (Jenn)}
\pdfinfo{
  /Title (pmhnp-anti-psych-meds.pdf)
  /Creator (Cheatography)
  /Author (Stormes RN (Jenn))
  /Subject (PMHNP Anti-Psych Meds Cheat Sheet)
}

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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{PMHNP Anti-Psych Meds Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Stormes RN (Jenn)} via \textcolor{DarkBackground}{\uline{cheatography.com/87444/cs/20366/}}}
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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Stormes RN (Jenn) \\
  \uline{cheatography.com/jenn} \\
  \end{tabulary}
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\columnbreak
\begin{tabulary}{5.8cm}{L}
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 27th August, 2019.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
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  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\end{multicols}}




\begin{document}
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\begin{multicols*}{2}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{Typical Anti-psychotic (FGA)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Haldol/Haliperidal} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{\seqsplit{Thorazome/chloropromazine}} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Serentil/mesoridazine} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Mellaril/Thoridazinel} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Permitil/Fluphenazine} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Trilafon/Perphenazine} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Stelazine/Trifluperazine} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Loxitane/loxapine} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Moban/Molindone} \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Navane/Thiothixene} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Typical/First Generation Drugs (FGA) are full D2 agonist causing a dopamine blockade which increases the cascade effect increasing the incident of EPS with low dopamine. \newline  \newline Neuro S/E  \newline Lower Dopamine \newline Efficacious \newline Can be more affordable for PT}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{Effects of Dopamine}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Low dopamine = parkinson symptoms} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{High dopamine = psychosis symptoms} \tn 
% Row Count 2 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Dopamine has impact on other neurotransmitters and hormones.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{EPS}}  \tn
% Row 0
\SetRowColor{LightBackground}
Acute Dystonia & Can occur in hours \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Akathisia & Can occur in days \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Parkinsonism & Can occur in weeks \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
Tardive Dyskinesia & Can occur in years \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Typical time frame for presentation of EPS symptoms in a patient taking Anti-psych meds.  There are other non-psych meds that can also increase the risk of EPS.   \newline  \newline EPS is less likely to occur with SGA, than with FGA: \newline -{}-\textgreater{}  FGA full blockade without the additional 5HT receptors, as in the SGA.  \newline -{}-\textgreater{} Partial agonism by some of the SGA at the D2 receptor site.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} x{7.2 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{DOPAMINE}}  \tn
% Row 0
\SetRowColor{LightBackground}
D & Drugs \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
O & psyhchOsis \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
P & Prolactin \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
A & Attention \tn 
% Row Count 4 (+ 1)
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M & Motivation \tn 
% Row Count 5 (+ 1)
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I & Involuntary Movements \tn 
% Row Count 6 (+ 1)
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\SetRowColor{LightBackground}
N & Nausea \tn 
% Row Count 7 (+ 1)
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\SetRowColor{white}
E & Energy \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Signs for too much Dopamine leading to psychosis.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.72 cm} x{5.28 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Other Important S/E by Pharmaceutical}}  \tn
% Row 0
\SetRowColor{LightBackground}
\seqsplit{Clozaril/clozapine} & blood concerns with agranulocytosis \tn 
% Row Count 2 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{8.4cm}{x{2.8 cm} x{5.2 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Atypical Anti-psych (SGA) Partial D2 Action}}  \tn
% Row 0
\SetRowColor{LightBackground}
\seqsplit{Abilify/aripiprizole} & D2 partial agonist + 5HT targets \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Rexulti/brexpiprizole} & D2 partial agonist + 5HT targets \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Vraylar/cariprazine} & D2 and D3 partial agonist + 5HT targets \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Partial dopamine agonism will lower dopamine levels, but not as much as the full agonist of FGA and some SGA.  SGA agonism (partial and full) will Increases the serotonin levels.  There is an unknown relationship between dopamine and serotonin in symptom relief of psychosis.  The agnoism effect on the 5HT receptors varies from pharmaceutical formulary and is not consistent within the classification of SGA.  \newline  \newline Typically, lower EPS with Neuro S/E but increase risk of Metabolic S/E.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4.64 cm} x{3.36 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Atypical Anti-psych (SGA) Full D2 Agonism}}  \tn
% Row 0
\SetRowColor{LightBackground}
Fanapt/Iliperidone & D2 agonist + 5HT \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Saphris/Asenapine & D2 agonist + 5HT \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Latuda/lurasidone & D2 agonist + 5HT \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
Seroquel/quetiapine & D2 agonist + 5HT \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
Zyprexa/olanzapine & D2 agonist + 5HT \tn 
% Row Count 5 (+ 1)
% Row 5
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Risperidal/risperidone & D2 agonist + 5HT \tn 
% Row Count 6 (+ 1)
% Row 6
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Clozaril/clozapine & D2 agonist + 5HT \tn 
% Row Count 7 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Full dopamine agonism at D2 lowers dopamine levels  SGA agonism of 5HT (partial and full) will Increases the serotonin levels.  There is an unknown relationship between dopamine and serotonin in symptom relief of psychosis.  The agnoism effect on the 5HT receptors varies from pharmaceutical formulary and is not consistent within the classification of SGA.  \newline  \newline Typically, lower EPS with Neuro S/E but increase risk of Metabolic S/E.  Cost can be a barrier to care with limited access.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{1.296 cm} x{2.304 cm} x{1.224 cm} x{2.376 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{4}{x{8.4cm}}{\bf\textcolor{white}{Long Acting Injectable (LAI)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\seqsplit{Aristada/Initio} & \seqsplit{aripiprizole} lauroxil (pro drug) & 4-8 weeks Glut Inj & Schizo; D2 partial agonist, 5HT \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\seqsplit{Risperidal} Consta & risperidone & 2-4 weeks Glut &  \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Invega/Sustenna} Trinza & \seqsplit{paliperidone} (component of Risperidal) & 1-3 \seqsplit{months} Glut &  \tn 
% Row Count 10 (+ 4)
% Row 3
\SetRowColor{white}
Geodon & ziprasidone & 2-4 weeks Glut &  \tn 
% Row Count 13 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\seqsplit{Zyprexa} & olanzapine & 2-4 weeks &  \tn 
% Row Count 15 (+ 2)
% Row 5
\SetRowColor{white}
\seqsplit{Vivitrol} & naltrexone & 30 days Glut & Opioid and ETOH addiction; in combination of Therapy \tn 
% Row Count 19 (+ 4)
% Row 6
\SetRowColor{LightBackground}
\seqsplit{Maintena} & \seqsplit{aripiprazole} (abilify & 30 days Delt or Glut & Schizo, BP1 in Adults \tn 
% Row Count 23 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}----}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{1.6 cm} x{6.4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{SGA Drug Ending Short Cuts r/t S/E}}  \tn
% Row 0
\SetRowColor{LightBackground}
-Apine & increase in sedation and weight gain with decrease in EPS symptoms \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
-Idone & decrease in sedation and weight gain with increase in EPS symptoms \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{-Piprazole} & decrease in weight gain with increase in EPS symptoms \tn 
% Row Count 8 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Known S/E with drug ending by class for the SGA.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

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