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34 Cards in this Set
- Front
- Back
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What is BiPolar?
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Manic Depression, extreme highs and lows
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BiPolar labeling of kids article
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39 fold increase from an estimated 20,000 visits from 1994 to 800,000 in 2003
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Who is more likely to have kids with bipolar?
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Older men
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Symptoms of BiPolar
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irritablity, restless, recklessness
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What kinds of drugs are given in bipolar?
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Almost all was offlabel
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What is Lithium?
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Lithium is the lightest of the alkali metals and has the similar characteristics with sodium. abundant in alkaline mineral spring waters
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What is lithium's half life?
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About half an oral dose is excreted within 18 to 24 hrs
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Does lithium get into the brain?
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Does not get into brain very well, .75/1.0 milliequivalent
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What is lithium's theraputic index?
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It has a narrow theraputic index
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Does lithium effect the normal person?
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No it only has an effect on bipolar ppl
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Sodium and lithium balance?
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when sweating out sodium lithum levels rise.Too much salt, low levels of lithium
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Side effects and toxicity of lithium?
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At plasma levels of 1.5 to 2- nausea diarreah, lethargy, abdominal px, ataxia, muscle weakness,slurred speech, nystagmus
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side effects ofchronic tx with lithium or depracote
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causes weightgain in 8 percent of baseline body weight
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long term lithium therapy side effects
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enlarged thyroid, rashes, cognitive effects,
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Lithium at high doses causes?
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Psychosis even death
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Is lithium a teratogen?
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Yes, causes cardiovascular disorders in first trimester, must discontinue drug before birth, toxic to newborn
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Pregnancy issues with lithium
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Must restart lithium within 24 hours of delivery, or will have serious manic attacks
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If you need to breastfeed as a bipolar which drug should u take?
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depracote
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What is the percentage of noncompliance with lithium?
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50% , suicidal behavior is high with ppl on lithium
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What percentage of bipolar paitents have reduced suicidal behaviors?
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77%
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What is the rate of suicidal increase for ppl who go off lithium?
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attempts fourteenfold
completed thirteenfold |
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Combination therapy with lithium?
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Patients on lower dose of lithium + anticonvulsant
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What is Lamotrigine?
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One of the only antiepileptic drug that will treat both manic and depressive phase.
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Substance Abuse big problem with bipolar patients?
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yes 55%, most patients with bipolar will only be treated for manic
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Valproic Acid (DepaKote)
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antiepileptic drug used in place of lithium, increases concentration of GABA
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Pharmacokinetics of Valproic Acid
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metabolized in liver will react with herbs, primarily excreted in urine, problem with protein binding,
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Can Valproic Acid be removed by hemodyalisis?
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No, protein bound
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Is Valproic Acid Contraindicated in pregnancy?
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Yes, It causes spina bifida
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Adverse reactions with valproic acid? (depakote)
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hepatotoxicity, blodd discrazia- abnormal bloodcells,
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Lamotrigine (lamictal)
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One of the few drugs that works for Lennox gastaut
causes stevens' johnsons syndrome- deadly rash |
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What is Lennox Gastaut?
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Worse siezures there are,as they are constant.
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How does Lamotrigine (lamictal) work?
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Probably blocks sodium channels, might block excitatory neurons
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What does Lamotrigine do to fetus?
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teratogen:Causes Cleft Pallet
Category C |
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What age can lamotrigine start being used?
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txt patients 2 yrs and up with tonic clonic seizures
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