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33 Cards in this Set
- Front
- Back
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First mood stabilizer approved
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LITHIUM
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Predictors of positive response to Li
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Mania
Lack of neurological or psychotic symptoms or substance abuse Non-rapid cycling |
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What are the main adverse events of Li therapy
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GI upset
Fine tremor POLYURIA, POLYDIPSIA - IATROGENIC DIABETES INSIPIDUS Also weight gain, worsening of dermatologic conditions, cognitive, hypothyroidism |
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What labs should you monitor in people on lithium
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RENAL FUNCTION - possibility of nephrotoxicity - relatively rare
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Is Li safe for pregnant women?
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NO - TERATOGENIC
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Name drugs which increase Li levels
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NSAIDS
DIURETICS ACE INHIBITORS |
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Name drugs that decrease Li levels
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Theophylline, caffeine
Acetazolamide Na --> if you restrict Na in iet will increase levels of Li and can lead to toxicity |
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Name drugs that may increase Li toxicity
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Methyldopa
Carbamazepine Ca channel blockers SSRI's Antipsychotic agents |
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Does Li have narrow or wide therapeutic index
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NARROW - lab levels need to be drawn to monitor for toxicity
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Which drug is 1st line therapy in mixed or rapid cycling episodes (also in patients with high BP and history of substance abuse)
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VALPROIC ACID
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What are the common side effects of valproic acid
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Sedation, tremor, nausea, diarrhea, weight gain, alopecia, mild LFT increase
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What are the rare serious side effects of valproic acid
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HEPATOTOXICITY
AGRANULOCYTOSIS |
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Does valproic acid have narrow or wide therapeutic index
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NARROW - need to draw blood levels to monitor for toxicity
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Is valproic acid safe for pregnant women"?
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NO - TERATOGENIC
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How is valproic acid eliminated?
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HEPATIC ELIMINATION
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VPA may increase levels of _
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Lorazepam
WARFARIN |
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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
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CARBAMAZEPINE
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What are the common side effects of carbamazepine
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Sedation, headache, ataxia, nausea, leukopenia
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What are serious but rare side effects of carbamazepine
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STEVENS JOHNSON SYNDROME
SIADH HEPATITIS |
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Is carbamazepine safe for pregnant women
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NO - TERATOGENIC
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How is carbamazepine eliminated
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HEPATIC ELIMINATION
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Which drugs can decrease carbamazepine levels
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Phenytoin
Phenobarbital |
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Carbamazepine together with clozapine cause _
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Bone marrow suppression
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Name drug that is possible 2nd line therapy option for acute mania and depression
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OXCARBAZEPINE
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Which serious side effects should you watch out for with oxcarbazepine
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RASH AND SIADH
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Oxcarbazepine increases metabolism of _
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BCP's - estrogen and progesterone
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Name adjunctive agents
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2nd generation anti-psychotics
Benzodiazepines Novel anticonvulsants Ca channel blockers Thyroid hormone |
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What are the 1st line adjuncts which reduce anxiety, agitation and insomnia and are useful during acute treatment
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BENZODIAZEPINES
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Name 2 most common benzodiazepines used for treatment of BP
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Lorazepam
Clonazepam |
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Name anticonvulsants used for treatment of BP
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Lamotrigine
Gabapentin Topiramate |
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Which anticonvulsant has FDA indication for maintenance therapy for bipolar, particularly good for Bipolar II with mainly depressive episodes
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LAMOTRIGINE
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Which drug decreases clearance of lamotrigine
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VPA
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Which anticonvulsant can lead to Stevens Johnson syndrome
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LAMOTRIGINE
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