Bipolar 4 Flashcards
when are CBC’s needed for patients on valproic acid
- CBC at baseline
- every month for 6 months
- every 6 months after
what are the BBWs of depakote
- hepatotoxicity
- hemorrhagic pancreatitis
- teratogenicity
when benefits outweigh risks with a pregnant patient, what should be given with depakote
5 mg of folic acid; decreases neural tube defects
what drug interactions can cause decreased valproic acid concentrations
- carbamazepine
- lamotrigine
- phenytoin
what drug interactions can cause an increase in valproic acid concentrations
- clarithromycin
- erythromycin
- felbamate
- isoniazid
what is the only indication for lamotrigine in treating bipolar disorder
only maintenance therapy for type I Bipolar disorder
what drug is most effective for preventing bipolar depression
lamotrigine
what is the initiating dose of lamotrigine
25 mg/day for 2 weeks (to decrease AEs)
what are the two most common side effects with lamotrigine
rash
steven johnsons syndrome
what is the goal dose of lamotrigine
200mg per day
what effect does valproic acid have on lamotrigine concentrations
prolongs the half life of lamotrigine; increasing lamotrigine conentration
what is the initiating dose of lamotrigine for patients on depakote
25 mg every other day
what is the initial dose of lamotrigine for patients on carbamazepine, phenytoin, phenobarbital, or oral contraceptives?
50 mg/ day for 2 weeks
what drug interactions decrease lamotrigine concentrations
- carbamazepine
- phenytoin
- phenobarbital
- oral contraceptives
initiation of lamotrigine can’t be within two weeks of what
viral infection
rash
vaccination
