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Psychiatry > Anti-convulsants (Mood stabilizers) > Flashcards

Anti-convulsants (Mood stabilizers) Flashcards

1
Q

3 indications?

A

BAD, cyclothymia, schizoaffective disorder

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2
Q

name the 3 classes of mood stabilizers?

A

lithium, anticonvulsants, antipsychotics

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3
Q

how do we choose type of Mood stabilizer?

A

side effects and target sx

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4
Q

name 3 anticonvulsants?

A

valproic acid (depakote), lamotrigine and carbamazepine

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5
Q

what is valproic acid used for?

A

mania prophylaxis (better than depression prophylaxis)

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6
Q

which patients are most likely to have a +ve repsonse to valproic acid?

A

rapid cycling patients, F>M, co-morbid substance issues, co-morbid anxiety disorders

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7
Q

what should be done before starting valproic acid?

A

baseline LFTs, pregnancy test and FBC

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8
Q

which pts should valproic acid be avoided and WHY?

A

women of child-bearing age - neural tube defects

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9
Q

how long until steady state is achieved with valproic acid?

A

4-5 days

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10
Q

how should valproic acid be monitored?

A

check FBC and LFTs after 12 hours of last dose

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11
Q

target level of valproic acid?

A

50-125

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12
Q

name 3 side effects of valproic acid?

A

thrombocytopenia, N+V, weight gain, tremor

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13
Q

what is the 1st line treatment for acute mania/ mania prophylaxis?

A

carbamazepine

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14
Q

indications of carbamazepine?

A

rapid cyclers

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15
Q

what should be done before starting carbamazepine?

A

baseline LFTs, FBC abd ECG

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16
Q

how should carbamazepine be monitored?

A

steady state after 5 days - check 12 hours after last dose and repeat FBC and LFTs

17
Q

goal target levels for carbamazepine?

A

4-12 mcg/ml

18
Q

name 3 SEs of carbamazepine?

A

rash (very common), N+V, aplastic anaemia

19
Q

indications for lamotrigine?

A

same as others + neuropathic pain

20
Q

what should be done before starting lamotrigine?

A

baseline LFTs

21
Q

titration of lamotrigine?

A

start with 25mg daily for 2 qeeks - then increase to 100mg

22
Q

what is a common SE of lamotrigine and what should be done if it appears?

A

rash - stop tx

23
Q

what could rash caused by lamotrigine indicate in severe cases?

A

SJS, toxic epidermal necrolysis

Psychiatry (8 decks)

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