bipolar Flashcards
risk factors for bipolar
genetics, neurotransmitters, neurobiology, endocrine, environmental factors
what is bipolar 1?
most severe form, with the highest mortality rate, and must have at least 1 manic episode
what is bipolar 2?
at least 1 hypomanic episode and 1 major depressive disorder.
more severe than cyclothyamic
what is cyclothyamic disorder?
alternate symptoms of mild to moderate depression for at least 2 years. rapid cycling is possible
what is the diagnostic criteria for bipolar 1?
- at least one MANIC episode
- three or more of symptoms
- symptoms cause an impairment in functioning or require hospitalization
what are the clinical features of mania?
D-distractibility
I-indiscretion
G-grandiosity
F-flight of ideas
A-activity increase
S-sleep deficit
T-talkativeness
how is someone diagnosed with bipolar 2?
presence of at least 1 major depression episode and at least one hypomanic episode
NEVER MANIC
what differentiates a manic episode from a hypomanic episode?
- not severe enought to impair social or occupational functioning
-not severe enough to need hospitalization
-no psychotic features
what is mixed features in regards to bipolar?
showing signs of depression and mania at the same time
cyclothiamic disorder s/s
present for at least 2 years
-multiple hypomanic symptoms (not an episode)
-symptoms present more than half the time (no more than 2 months without)
-
what are possible moods with bipolar?
mania, hypomania, depression, lability
what are possible behaviors with bipolar?
agitated, manipulative, restless, pacing
what are possible thought processes with bipolar?
loose, tangential, and flight of ideas
what are possible thought contents with bipolar?
grandiose, paranoid, and persecutory
what are possible speech patterns with bipolar?
pressured, circumstantial, and clang
what medications are used for acute mania?
lithium or divalproex plus an antipsychotic
(Benzos if extreme agitation)
what meds are used for mood stabilization?
divalproez
carbamazepine
lamotrigine
gabapentin
LITHIUM CARBONATE
what are the contraindications for lithium?
CVD, renal disease, brain damge, thyroid disease, pregnant or breast-feeding
what are the early signs of lithium toxicity?
GI upset, coarse hand tremor, confusion, hyperirritability, EKG changed, sedation, and incoordination
how do we treat lithium toxicity early?
stop meds and send blood for labs
what are the advanced signs of lithium toxicity?
ataxia, giddiness, EKG changes, clonic movements, large urine output, severe hypotension, seizure, stupor, coma,
how do we treat advanced lithium toxicity
hospitalized, drug is stopped, whole bowel irrigation to prevent further absorption
what is the nursing consideration for divalproex
check serum levels,
s/e of carbmazepine
risk for low WBC
check hepatic and renal function
Rash
what is the major effect with lamotrigine?
RASH!!!
deadly by leading to steven johnson syndrome
Stop med
