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17 Cards in this Set
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A patient gave the pharmacist a prescription for Depakene 150 mg BID #60. Which of the following is an appropriate generic substitution for Depakene? Answer AQuetiapine BLithium CCarbamazepine DDivalproex EValproic acid |
EValproic acid |
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A pharmacist is rounding in a lock-down unit. A patient with bipolar I is found to be pregnant. The pharmacist is asked about drug use in pregnancy. Which of the following statements is correct? (Select ALL that apply.) Answer AValproic acid is a dangerous drug to use in pregnancy, and is most dangerous when taken during the first trimester. It can cause neural tube defects in the newborn, and permanent cognitive damage. BLurasidone is a second-generation antipsychotic used for bipolar; it is Pregnancy Category B. CLithium is considered the safest option in pregnancy and is the "drug of choice" for treating bipolar II in pregnant women. DMost of the bipolar medications are Pregnancy Category C. ELithium can cause heart damage to the newborn, along with cognitive dysfunction. |
AValproic acid is a dangerous drug to use in pregnancy, and is most dangerous when taken during the first trimester. It can cause neural tube defects in the newborn, and permanent cognitive damage. BLurasidone is a second-generation antipsychotic used for bipolar; it is Pregnancy Category B. ELithium can cause heart damage to the newborn, along with cognitive dysfunction. |
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Margie has used lithium for many years. Normally, she has a fine hand tremor. Today, her hand is visibly shaking. She is nauseous, and vomited the little she ate this morning. Her speech is slurred and confused. She appears to have difficulty walking into the examination room. Margie is found to have lithium toxicity. Which of the following can contribute to lithium toxicity? (Select ALL that apply.) Answer AIncreased salt intake BReduced renal function CDecreased intake of NaCl DTaking the lithium with fatty food EElevated potassium
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BReduced renal function CDecreased intake of NaCl |
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A pharmacist will counsel a patient beginning lithium therapy for bipolar disorder. Which of the following statements regarding lithium are correct? (Select ALL that apply.) Answer AIn rare cases this drug can cause damage to your liver. If you feel very tired and lose your appetite, or if your stool becomes light in color (or your skin becomes yellow-ish), you need to be seen by your doctor right away. BYou should not become pregnant while using this medicine. If you do become pregnant, see the doctor right away. CIf you feel very nauseated, or if your stools are loose and watery, and if you feel confused (with slurring speech, or trouble walking, it could mean the amount of medicine in your body is too high and you will need to see the doctor right away. DThis medicine can make you feel thirsty, and then you will need to use the bathroom more often. In order to prevent becoming dehydrated, drink water often and take a water bottle with you when you go out. ETake this medicine on an empty stomach one hour before or two hours after meals. |
BYou should not become pregnant while using this medicine. If you do become pregnant, see the doctor right away. CIf you feel very nauseated, or if your stools are loose and watery, and if you feel confused (with slurring speech, or trouble walking, it could mean the amount of medicine in your body is too high and you will need to see the doctor right away. DThis medicine can make you feel thirsty, and then you will need to use the bathroom more often. In order to prevent becoming dehydrated, drink water often and take a water bottle with you when you go out. |
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A pharmacist will counsel a patient beginning valproic acid therapy for bipolar disorder. Which of the following statements regarding valproic acid are correct? (Select ALL that apply.) Answer AIn rare cases this drug can cause damage to your liver. If you feel very tired and lose your appetite, or if your stool becomes light in color (or your skin becomes yellowish), you need to be seen by your doctor right away. BYou should not become pregnant while using this medicine. If you do become pregnant, see the doctor right away. CIn rare cases this drug can cause damage to your pancreas. If you become nauseated, with a loss of appetite and pain around your abdomen (stomach area), you need to be seen by your doctor right away. DThis medication can cause the cells that fight infection to become very low. You need to watch for symptoms of having an infection, such as feeling weak and tired, or running a fever. If this happens you should see your doctor as soon as possible. ETake this medicine on an empty stomach. |
AIn rare cases this drug can cause damage to your liver. If you feel very tired and lose your appetite, or if your stool becomes light in color (or your skin becomes yellowish), you need to be seen by your doctor right away. BYou should not become pregnant while using this medicine. If you do become pregnant, see the doctor right away. CIn rare cases this drug can cause damage to your pancreas. If you become nauseated, with a loss of appetite and pain around your abdomen (stomach area), you need to be seen by your doctor right away. |
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Holly is a 50 year-old female who has been using lithium as a mood stabilizer for bipolar disorder for three years. Holly presents to the clinic for her six-month follow up. She complains of fatigue, constipation, dry skin and mental sluggishness. Which of the following lab tests are most appropriate to find the probable cause of these symptoms? Answer AAST and ALT BCH and LDL CBUN and serum creatinine DTSH and FT4 ECBC |
DTSH and FT4 |
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A pharmacist will counsel a patient beginning lamotrigine therapy for bipolar disorder. Which of the following statements regarding lamotrigine are correct? (Select ALL that apply.) Answer AWhen you start this medication, you will need to slowly increase the dose; that's why it comes in a dosing packet. BDo not take other medicines or over-the-counter products without discussing them first with your doctor or pharmacist. CIf you develop a rash that quickly becomes serious; do not take more than prescribed and see your doctor right away if this happens, or if the doctor is not available to consult with you, get emergency medical help. DThis medicine can cause you to feel somewhat dizzy and tired. EThe brand name of this medicine is Latuda. |
AWhen you start this medication, you will need to slowly increase the dose; that's why it comes in a dosing packet. BDo not take other medicines or over-the-counter products without discussing them first with your doctor or pharmacist. CIf you develop a rash that quickly becomes serious; do not take more than prescribed and see your doctor right away if this happens, or if the doctor is not available to consult with you, get emergency medical help. DThis medicine can cause you to feel somewhat dizzy and tired. |
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A pharmacist will counsel a patient beginning lithium therapy for bipolar disorder. Which of the following statements regarding lithium are correct? (Select ALL that apply.) Answer AYou should not become pregnant while taking this medicine; it is likely to harm the baby, but if you do, contact your doctor right away. BIt is helpful to get lots of sun to help improve your mood when using this medicine. CThis medication can cause a light tremor in your hands; if you notice the tremor looks worse (much more noticable), it can mean the level of drug in your body is too high and you should see the doctor right away. DPrepared frozen food, fast food and Chinese food usually contain a lot of salt; the salt in your diet needs to be about the same amount every day, so you need to think about what you are eating. EThis medication can make your weight go up; it is helpful to get exercise, such as walking, and stay away from sweets and sugary drinks. |
AYou should not become pregnant while taking this medicine; it is likely to harm the baby, but if you do, contact your doctor right away.
CThis medication can cause a light tremor in your hands; if you notice the tremor looks worse (much more noticable), it can mean the level of drug in your body is too high and you should see the doctor right away. DPrepared frozen food, fast food and Chinese food usually contain a lot of salt; the salt in your diet needs to be about the same amount every day, so you need to think about what you are eating. EThis medication can make your weight go up; it is helpful to get exercise, such as walking, and stay away from sweets and sugary drinks. |
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What are the indications for Symbyax? (Select ALL that apply.) Answer ATreatment of tics due to Tourette's or other conditions BTreatment-resistant depression CBipolar depression DAntipsychotic-induced metabolic syndrome EFibromyalgia
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BTreatment-resistant depression CBipolar depression |
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In the past few years, drugs typically used for schizophrenia have been approved for various states of bipolar. Which of the following drugs can be used for bipolar disorder (various states), according to the FDA-indications? (Select ALL that apply.) Answer AThioridazine BHaloperidol CAsenapine DQuetiapine EAripiprazole
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CAsenapine DQuetiapine EAripiprazole |
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Margie has been using lithium for most of her adult life. She cannot afford air conditioning and has been living in an apartment where the temperature has been over 100 degrees for the five days. She succumbed to the heat and has been brought into the hospital with dehydration, acute renal failure and lithium toxicity. The lithium level is taken and found to be 3.2 mEq/L. The following adverse effects may be present when the lithium concentration is at this level: (Select ALL that apply.) Answer ASevere CNS sedation BFulminant hepatic failure CArrhythmias DSeizure EComa, death could occur |
ASevere CNS sedation
CArrhythmias DSeizure EComa, death could occur |
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Bipolar disorder can cause the following problems in patients: (Select ALL that apply.) Answer ATics and other vocal outbursts BExcessive gambling CRisky sexual behaviors DHigher risk of suicide ETrouble at work due to poor performance |
BExcessive gambling CRisky sexual behaviors DHigher risk of suicide ETrouble at work due to poor performance |
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What is the correct serum trough range for monitoring lithium therapy? Answer A0.1-0.5 mg/L B1-1.2 mEq/L C0.4-1.2 mcg/mL D0.6-1.2 mEq/L E5-10 mg/L |
D0.6-1.2 mEq/L |
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Side effects of divalproex sodium may include: (Select ALL that apply.) Answer AGI upset BAlopecia CSedation DIron overload EWeight Loss |
AGI upset BAlopecia CSedation |
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Lithium must be kept within a "narrow therapeutic range". What signs and symptoms may be present if the lithium concentration is elevated? (Select ALL that apply.) Answer ADiarrhea BAggravation and anxiety CCogwheel rigidity DA "drunk-like" uncoordinated walk ECoarse hand tremor |
ADiarrhea
DA "drunk-like" uncoordinated walk ECoarse hand tremor |
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Clara is known to your pharmacy. She states she is depressed due to her husband's gambling streaks where he has racked up high credit card debts. She states that he is either engaging in risky behavior or "moping around the house." Clara says that her husband finally went to see a doctor, who diagnosed her spouse with 'bipolar II disorder." She asks you what this means. Pick the most reasonable explanation: Answer AThis is a disease notable for causing fatigue, muscle weakness and cognitive decline. BThis is a disease where the person is likely to have psychosis, such as hearing voices. CThis is a disease where the person has periods of elevated or irritable mood, which alternates with periods of very sad mood. DThis is a disease where the brain cells become demyelinated. EThis is a disease where the brain cells lose dopamine, which is replaced with drugs such as Sinemet.
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CThis is a disease where the person has periods of elevated or irritable mood, which alternates with periods of very sad mood. |
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Choose the correct descriptions concerning lithium, carbamazepine and valproic acid use in pregnancy: Answer AThey are rated Pregnancy Category B. BThey are rated Pregnancy Category C. CThey are rated Pregnancy Category X. DThese drugs are known to cause birth defects; they should only be used if the benefit clearly outweighs the risk. EThese drugs are safe to use in pregnancy. |
DThese drugs are known to cause birth defects; they should only be used if the benefit clearly outweighs the risk. |
