Bipolar

Question 0

Atypical antipsychotics: treats bipolar

Answer 0

Risperidone (Risperdal)
Quentiapine (Seroquel)
Olanzapine (Zyprexa)

Question 1

Anticonvulsants: controls mania

Answer 1

Valproic acid (Depakote): monitor LF with LFT and CBC
Lamotrigine (Lamictol): monitor for rash (SJS)

Question 2

Typical antipsychotics: acute manic phase ➡️ most commonly cause EPS

Answer 2

Butyrophenone (Haldol)

Chlorpromazine (Thorazine); avoid in elders bc anticholinergic effects

Question 3

Treatment for EPS

Answer 3

Antihistamine (Vistaril or Cogentin)

Question 4

Antidepressant: SSRIs: depression in bipolar

Answer 4

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)

Question 5

Anticonvulsant s/e

Answer 5

N/V, skin rash, bruising, prolonged bleeding time, liver toxicity

Question 6

Atypical antipsychotic s/e:

Answer 6

Drowsiness, insomnia, EPS(Risperdal), weight gain

Question 7

Typical antipsychotic s/e:

Answer 7

EPS, anticholinergic effects, ⬇️ sex drive, photosensitive, severe dysrhythmias

Question 8

SSRI s/e:

Answer 8

Insomnia, sexual dysfunction, headache, weight gain, black box warning, serotonin syndrome

Question 9

Anti-manic: controls acute manic episodes

Answer 9

Lithium (Lithobid)

Question 10

Lithium levels

Answer 10

Acute mania: 1.0-1.5
Maintenance: 0.6-1.2
Toxicity: > 1.5

Question 11

Implications for lithium

Answer 11

Take with food, maintain adequate sodium intake, 2500-3000mL/ day

Question 12

Lithium toxicity

Answer 12

Dizziness, tinnitus, nausea, muscle weakness, fine tremor

Question 13

Antidepressant: MAOI: depression in bipolar

Answer 13

Isocarboxizide (Marplan)

Sergiline (EmSam) *transdermal

Question 14

MAOI s/e:

Answer 14

Hypertensive crisis with foods containing tyramine, anxiety, insomnia, orthostatic hypotension, black box warning

Question 15

Antihypertensives

Answer 15

Clonidine (Catapres)

Question 16

3rd generation antipsychotics

Answer 16

Ariprirozole (Abilify)