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26 Cards in this Set
- Front
- Back
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your pt is newly Dx'd with bipolar, what meds will you prescribe?
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Lithium overlapped with Valproic Acid
Lithium 400mg TID Valproic Acid 20mg/kg/day bacause it takes 1-2 weeks for lithium to work |
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What is the serum level of Lithium for acute mania?
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0.8-1.0 meq/L
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What is the initial dosing of lithium?
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400mg TID
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what tests should you do before starting lithium?
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CBC
electrolytes renal funtion UA Thyroid function tests ECG |
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T/F You should avoid lithium during the first trimester of pregnancy
Why? |
True because it has teratogenic effects
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A pt on lithium develops a tremor, what do you do?
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reduce the drug, give BB(propanolol-crosses blood-brain barrier)
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when should you stop lithium therapy?
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In case of:
Rash Hypothyroidism Interstitial fibrosis |
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which drugs increase lithium?
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Thiazides
NSAIDS ACEI |
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what effect does lithium have on NMBs?
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Li prolongs their action
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Name 3 anticonvulsants (AEDs)
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Valproic Acid
Carbamazepine Lamotrigine These are used as Mood Stablizers to reduce manic and depressive episodes |
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Which Antipsychotics are approved for Bipolar?
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GEARZS
Geodone (QT prol.monitor K/mg) Enviga Abilify - injectable Risperdal Zyprexa- for acute (iv) Seroquil |
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what causes Schizophrenia?
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abnormal dopamine levels
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what are the 4 dopamine tracts
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Mesolimbic > Dopa
Mesocortical < Dopa Nigrostriatal- EPS from DA blockade Tuberoinfundibular- if blocked will > prolactin |
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Name the types of Schizo
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Paranoid
Disorganized Catatonic Undifferentiated Residual |
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Name the Atypical antipsychotics
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Geodon- check K/mg
Abilify Risperdal Zyprexa Seroquel Clozapine- check CBC |
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What's a S.E of Clozapine?
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Agranulocytosis
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what are the side effects of conventional phenothiazines
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EPS
Neuroleptic malignant Syndm Galactorrhea Tardive Dyskenisia Sedation Sexual dysfunction Wt gain |
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This is a life-threatening, neurological disorder most often caused by an adverse reaction to high doses of neuroleptic or antipsychotic drugs.
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Neuroleptic malignant syndrome
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What is the MOA of antipsychotics?
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Antagonize the D2 receptors
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How does lithium effect the thyroid?
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Reduces synthesis and release of thyroid hormone
so watch for hypothyroidism |
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how does pregnancy affect GFR and Lithium levels?
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GFR is increased so Lithium levels will decrease
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which atypical antipsychotic should not be used for sleeping aid with the elderly?
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Seroquel
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Presence of hypomanic episodes and majore depressive episodes
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Bipolar II
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what type of drugs are mood stabilizers
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Most are anticonvulsants, except for lithium
Carbamazepine Valproic Acid Gabapentine Lamotrigine Oxacarbazepine Topamax |
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Which drugs are used to treat depression?
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SSRI
MAOI TCA |
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Name some Anxiolytics (BZDs) used to treat Bipolar
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Halcion
Ativan Valium Xanax |
