Bipolar 2 Flashcards
what are 3 points about the desired outcomes of treating bipolar disorder
- aim for recovery, not limited improvement
- select drug regimens that are well tolerated
- assess acute episodes vs. maintenance drug needs
what is the ‘gold standard’ for bipolar disorder treatment
lithium
what anticonvulsants can be used for treated bipolar disorder
- valproic acid
- lamotrigine
- carbamazepine
is lithium indicated for acute or maintenance therapy of bipolar disorder
indicated for both
what is monotherapy of lithium not indicated for?
rapid cyclers or mixed states
when should labs be taken after initiating lithium
after 3-5 days (steady state is 5 days)
how is lithium metabolized/ excreted
renally, no hepatic metabolism
what pre-lithium work up is required
CBC Urinalysis Pregnancy test Thyroid function test Renal function EKG Electrolytes
why is CBC needed with pre lithium work up
can cause leukocytosis
what electrolyte imbalance is common with lithium
hyponatremia
what is the initial dosing range of lithium for bipolar disorder
600-900mg/day
If there is a need to raise lithium levels by 0.3 mEq/L, how much lithium should be given
300 mg
what are the therapeutic concentration levels of lithium for acute mania?
0.8-1.2
what are the therapeutic concentration levels of lithium for maintenance in treating bipolar disorder
0.6-1
when should labs be taken for a patient on lithium for most accurate levels?
12 hours after a dose
