Match each patient's clinical scenario and specific medication requirement with the most appropriate second-generation antipsychotic.
- A 24-year-old man with schizophrenia is started on an antipsychotic that acts as a dopamine D2 partial agonist. Shortly after, he develops severe inner restlessness and an inability to sit still.Aripiprazole
- A 33-year-old woman with acute schizophrenia is prescribed an antipsychotic that must be taken with a 500-calorie meal for adequate absorption. A baseline electrocardiogram is ordered due to a known dose-dependent risk of QTc prolongation.Ziprasidone
- A 45-year-old man with schizoaffective disorder is prescribed a medication formulated specifically for sublingual administration to bypass extensive first-pass hepatic metabolism. He is told not to eat or drink for 10 minutes after dosing.Asenapine
- A 30-year-old woman with bipolar depression is prescribed an agent with potent 5-HT7 receptor antagonism. She is instructed to take the medication with a meal of at least 350 calories to ensure adequate clinical efficacy.Lurasidone
Answer
The patient with akathisia and D2 partial agonism matches with Aripiprazole. The patient requiring a 500-calorie meal and an ECG for QTc prolongation matches with Ziprasidone. The patient requiring sublingual administration to bypass first-pass metabolism matches with Asenapine. The patient with bipolar depression requiring a 350-calorie meal matches with Lurasidone.
Each antipsychotic possesses distinct pharmacokinetic and pharmacodynamic properties that dictate its administration. Aripiprazole is a partial D2 agonist causing akathisia. Ziprasidone requires a 500-calorie meal and can prolong the QTc interval. Asenapine must be taken sublingually to avoid first-pass metabolism. Lurasidone requires a 350-calorie meal and acts at 5-HT7 receptors for treating bipolar depression.
Step-by-Step Solution
Key Concept
Pharmacokinetic and pharmacodynamic profiles of second-generation antipsychotics