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26 Cards in this Set

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your pt is newly Dx'd with bipolar, what meds will you prescribe?
Lithium overlapped with Valproic Acid

Lithium 400mg TID
Valproic Acid 20mg/kg/day

bacause it takes 1-2 weeks for lithium to work
What is the serum level of Lithium for acute mania?
0.8-1.0 meq/L
What is the initial dosing of lithium?
400mg TID
what tests should you do before starting lithium?
CBC
electrolytes
renal funtion
UA
Thyroid function tests
ECG
T/F You should avoid lithium during the first trimester of pregnancy

Why?
True because it has teratogenic effects
A pt on lithium develops a tremor, what do you do?
reduce the drug, give BB(propanolol-crosses blood-brain barrier)
when should you stop lithium therapy?
In case of:

Rash
Hypothyroidism
Interstitial fibrosis
which drugs increase lithium?
Thiazides
NSAIDS
ACEI
what effect does lithium have on NMBs?
Li prolongs their action
Name 3 anticonvulsants (AEDs)
Valproic Acid
Carbamazepine
Lamotrigine

These are used as Mood Stablizers to reduce manic and depressive episodes
Which Antipsychotics are approved for Bipolar?
GEARZS

Geodone (QT prol.monitor K/mg)
Enviga
Abilify - injectable
Risperdal
Zyprexa- for acute (iv)
Seroquil
what causes Schizophrenia?
abnormal dopamine levels
what are the 4 dopamine tracts
Mesolimbic > Dopa
Mesocortical < Dopa
Nigrostriatal- EPS from DA blockade
Tuberoinfundibular- if blocked will > prolactin
Name the types of Schizo
Paranoid
Disorganized
Catatonic
Undifferentiated
Residual
Name the Atypical antipsychotics
Geodon- check K/mg
Abilify
Risperdal
Zyprexa
Seroquel
Clozapine- check CBC
What's a S.E of Clozapine?
Agranulocytosis
what are the side effects of conventional phenothiazines
EPS
Neuroleptic malignant Syndm
Galactorrhea
Tardive Dyskenisia
Sedation
Sexual dysfunction
Wt gain
This is a life-threatening, neurological disorder most often caused by an adverse reaction to high doses of neuroleptic or antipsychotic drugs.
Neuroleptic malignant syndrome
What is the MOA of antipsychotics?
Antagonize the D2 receptors
How does lithium effect the thyroid?
Reduces synthesis and release of thyroid hormone

so watch for hypothyroidism
how does pregnancy affect GFR and Lithium levels?
GFR is increased so Lithium levels will decrease
which atypical antipsychotic should not be used for sleeping aid with the elderly?
Seroquel
Presence of hypomanic episodes and majore depressive episodes
Bipolar II
what type of drugs are mood stabilizers
Most are anticonvulsants, except for lithium

Carbamazepine
Valproic Acid
Gabapentine
Lamotrigine
Oxacarbazepine
Topamax
Which drugs are used to treat depression?
SSRI
MAOI
TCA
Name some Anxiolytics (BZDs) used to treat Bipolar
Halcion
Ativan
Valium
Xanax