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33 Cards in this Set

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First mood stabilizer approved
LITHIUM
Predictors of positive response to Li
Mania

Lack of neurological or psychotic symptoms or substance abuse

Non-rapid cycling
What are the main adverse events of Li therapy
GI upset

Fine tremor

POLYURIA, POLYDIPSIA - IATROGENIC DIABETES INSIPIDUS

Also weight gain, worsening of dermatologic conditions, cognitive, hypothyroidism
What labs should you monitor in people on lithium
RENAL FUNCTION - possibility of nephrotoxicity - relatively rare
Is Li safe for pregnant women?
NO - TERATOGENIC
Name drugs which increase Li levels
NSAIDS

DIURETICS

ACE INHIBITORS
Name drugs that decrease Li levels
Theophylline, caffeine

Acetazolamide

Na --> if you restrict Na in iet will increase levels of Li and can lead to toxicity
Name drugs that may increase Li toxicity
Methyldopa

Carbamazepine

Ca channel blockers

SSRI's

Antipsychotic agents
Does Li have narrow or wide therapeutic index
NARROW - lab levels need to be drawn to monitor for toxicity
Which drug is 1st line therapy in mixed or rapid cycling episodes (also in patients with high BP and history of substance abuse)
VALPROIC ACID
What are the common side effects of valproic acid
Sedation, tremor, nausea, diarrhea, weight gain, alopecia, mild LFT increase
What are the rare serious side effects of valproic acid
HEPATOTOXICITY

AGRANULOCYTOSIS
Does valproic acid have narrow or wide therapeutic index
NARROW - need to draw blood levels to monitor for toxicity
Is valproic acid safe for pregnant women"?
NO - TERATOGENIC
How is valproic acid eliminated?
HEPATIC ELIMINATION
VPA may increase levels of _
Lorazepam

WARFARIN
Name drug that is a 2nd line therapy, effective in acute mania and maintenance therapy, good response in mixed mania, neurologic disease, no family history of mood disorders
CARBAMAZEPINE
What are the common side effects of carbamazepine
Sedation, headache, ataxia, nausea, leukopenia
What are serious but rare side effects of carbamazepine
STEVENS JOHNSON SYNDROME

SIADH

HEPATITIS
Is carbamazepine safe for pregnant women
NO - TERATOGENIC
How is carbamazepine eliminated
HEPATIC ELIMINATION
Which drugs can decrease carbamazepine levels
Phenytoin

Phenobarbital
Carbamazepine together with clozapine cause _
Bone marrow suppression
Name drug that is possible 2nd line therapy option for acute mania and depression
OXCARBAZEPINE
Which serious side effects should you watch out for with oxcarbazepine
RASH AND SIADH
Oxcarbazepine increases metabolism of _
BCP's - estrogen and progesterone
Name adjunctive agents
2nd generation anti-psychotics

Benzodiazepines

Novel anticonvulsants

Ca channel blockers

Thyroid hormone
What are the 1st line adjuncts which reduce anxiety, agitation and insomnia and are useful during acute treatment
BENZODIAZEPINES
Name 2 most common benzodiazepines used for treatment of BP
Lorazepam

Clonazepam
Name anticonvulsants used for treatment of BP
Lamotrigine

Gabapentin

Topiramate
Which anticonvulsant has FDA indication for maintenance therapy for bipolar, particularly good for Bipolar II with mainly depressive episodes
LAMOTRIGINE
Which drug decreases clearance of lamotrigine
VPA
Which anticonvulsant can lead to Stevens Johnson syndrome
LAMOTRIGINE