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24 Cards in this Set
- Front
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Bipolar 1 |
manic and depressive episodes , mixed |
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Bipolar 2 |
Hypomanic, depressive. No FULL ON MANIA |
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Mania: expansive vs irritable need to see this for 1 week |
Expansive: not normal behavior. They think all is right with the world. sex with stangers - irritable form is irritable |
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For acute mania(bi polar1) there needs to be impairment of function: |
stop going to work, drains bank account. EMPIRE Buying sprees in Manic phase / poor judgement in business ventures |
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need at least 4 symptoms microwave story |
grandiosity / decreased need for sleep/pressured speech/ flights of speech/ involvment / easily distracted/ self importance |
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Some patients with acute mania may have? anti deprressant to bipolar when in depressive phase will do what? |
psychotic symptoms like hallucinations. some drs treat for schizo. YOUll make them fluctuate outta depression into MANIa |
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HYPOmania |
less severe form of mani. no dellusion / hallucinations |
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mixed features |
manic and hypomanic at the same time |
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dont know why ppl have bipolar disorder |
DONT KNOW but 90% of time its relative linked. genetic |
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presenting symptoms of mania diagnostic : |
difficult dont want to confuse with schizo(manic) or depression. some drugs trigger bipolar pt into manic phase |
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Life ling disorder: put pt into remission means put them into stable normal mood what kind of treatment |
mainstay treatment are mood stabalizers! Lithium is the newest drugs. we use anticonvulsents valproic acid anti psychotics are used |
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mood stabilizer is deceiving |
cant use them interchnagebly. some drugs favor manic side some favor depressive side. some drugs for manitance some for acute |
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Valproate (valproic acid) and Depakote used for |
acute and Maintenance |
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Lithium used for |
MANIA and is acute and maintenance |
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Lamotrigene or lamictal |
Bipolar 1 MAINTENANCE ONLY! be aware of rash |
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Combo tretament : Symbyax |
olanzapine + Fluoxetine approved for maintenance |
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Quetipapine and Lurasidone |
mania and mixed actute and maintenance |
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Adjunctivly use |
anti depressants |
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Lithium |
GOLD STANDARD FOR TREATING BI POLAR DISORDER NArrow theraputic window. ppl toxic from lithium ppl die from it. KNOW SIDE EFFECT PROFILE. |
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VALPROIC ACID |
SILVER star therapy - VERY GOOD shows better efficacy in ppl who have mixed states )depression and manai same time) -irritable /dysphorric mania - rapid cycle valproic acid works better! |
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lithium has a long half life |
even with good renals ppl can be toxic with lithium |
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treat D Insipidius with |
Diuretic loop and thiazide |
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toxic on lithium levels greater than reversible ? related to high level concentrations were and For HOW LONG will tell you what? so you do what to see? |
greater than 2 NON REVERSIBLE ! how severe and toxic it will be take a level !! |
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if pt is on nsaid / indomethacin /ibu these drugs can increase or decrease lithium ? also diuretic/ ace inhibitos salt restriced diet SALT in general increases levels caffine theophyline : DECREASE levels |
It can INCREASE lithium so decrease lithium dose since these increase levels |
