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57 Cards in this Set

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  • Back
bipolar
imbalance of neurotransmitters
manic episode
elevation in norepi
depression
dec norepi
dysregulation of GABA
deficiency in GABA -> mania due to unopposed excitatory neurotransmitters
GABA
inhibitory neurotransmitter
unopposed excitatory neurotransmitter
dopamine
norepi
Ca conc in CSF
effect the exitability of neurons

factor in depression to mania
G proteins
signal transduction and activation of 2nd messenger sys for var neurotransmitters
hyperactive G proteins
mood instability
G proteins + glutamate
long term potentiation and cycling of mood disorders
inhibit G protein linked mechanism
Lithium
sx of mania
grandiose ideations
expansive self esteem
pressured speech
racing thoughts
flight of ideas
distratability
psychomotor agitation
engaging in dangerous and high risk activities
mixed episode
coexistence of manic and depressive sx for at least 1 week
mood incongruent
asa mixed episode
bipolar 1 disorder
at least 1 manic or mood episode
bipolar 2 disorder
never exp a manic episode
exp 1 or more depressive episodes
exp 1 hypomanic episode
cyclothymia
depressive and hypomanic sx persist for 2 yrs
rapid cycling
dx when pt has exp at lest 4 depressive,manic,hypomanic or mixed episoded w/in 12 mo period
primary agts in trmt of bipolar
lithium
anticonvulsants
mood stabilizers
anticonvulsants
olanzapine
only atypical antipsyc for trmt of acute mania
alternative to olanzapine
risperidone
quetapine
ziprasidone
first line agts bipolar trmt
lithium
lamotrigine
1st line due to less risk for mania
bupropion
paroxetine
lorazepam
short term mgmt of acute agitation assoc w/ mania
lithium indication
1st line therapy for trmt and prevention of bioilar except in mixed episodes or rapid cycling
lithium chemistry
monovalent cation
2 clinically relevant lithium salts
lithium carbonate
lithium citrate
food
delay absorption but does not affect the extenet of absorption
distributes into total body water and penetrates many body tissues
lithium
lithium clearance directly proportional
GFR
not metabolized and its primarily eliminated thru kidneys
lithium
lithium moa
affect membrane stabilization

augment homeostasis by enhancing the fxn of 2ndary messenger sys
secondary messenger sys
cyclic adenosine monophosphate
cyclic guanosine monophosphate
phosphatidylinositol
inhibit norepi release and accelerate its metabolism
lithium
dec rec sensitivity and inc presynaptic reuptake of norepi and 5HT
lithium
lithium therapeutic range
0.5 - 1.5 mEq/L
valproic acid - vpa
anticonvulsant
vpa indication
acute mania
mixed mania
rapid cycling
vpa moa
related to gaba modulation and 2nd messenger sys
vpa drug interaxn
cimetidine
chlorpromazine
erythromycin
delbamate
salicylates
dec vpa conc
rifampin
pehnobarb
lamotrigine
phenytoin
cbz
inc warfarin and zidovudine
vpa
lab test for vpa
cbc
liver fxn test
cbz indication
anticonvulsant
cbz moa
modulate norepi and G protein bound linked 2nd messenger sys - cAMP
cbz se
induces enzymatic metabolism
monitor for cbz
serum conc
drug interaxn
lab test for cbz
cbc
liver fxn test
thyroid stimulating hormone
electrolytes
bun
creatinine
newer mood stabilizer
lamotrigine
gapapentin
oxcarbazepine
lamotrigine chemistry
similar to phenytoin and cbz
lamotrigine moa
blk Na mediated release of glutamate and aspartate at low conc

high con - blks gaba and acetylcholine release
gabapentin adv eff
somnolence
nystagmus
dizzy
ataxia
fatigue
oxcarbazepine
alternative to cbz
leukocytosis
lithium
leukopenia
bld dyscrasia
cbz and vpa
birth defects
lithium
vpa
cbz