Bipolar and pharm Flashcards
Bipolar I
Hx of at least one manic episode, with or without past major depressive episode.
Bipolar II
History of at least one episode of major depression and at least one hypomanic episode.
NO hx of manic episode
Manic episode
A distinct period of abnormally and persistently elevated mood lasting at east 1 wk.
Significant impairment
Often leads to arrest, hospitalization
Bipolar is genetic.
Believe it.
Rapid cycler
At least 4 mood changes in one year.
Bipolar II has greater risk of?
Attempting and completing suicide.
Marital discord
Generalized depression
Cyclothymia
Hypomanic and depression symptoms, frequently switching.
Depression is not major
Lithium
Significantly decreases frequency and severity of both manic and depressive episodes in about 70% of pts.
Lithium SE
Low therapeutic index Polydipsia, polyuria Edema, weight gain Thyrotoxic Tremor
Valproate Brand name
Depakote
Valproate
Becoming recognizes as first line.
Less SE
Quick onset
Valproate SE
Weight gain N/V Hair loss Tremor Liver failure Thrombocytopenia Pancreatitis
Carbazepine brand name
Tegretol
Tegretol
Comparable efficacy to lithium
Tegretol SE
N/V Hyponatremia Rash (SJ) Drowsiness, blurred vision Blood dyscrasias
Lamotrigine brand name
Lamictal
Lamictal
Treats bipolar depression w/o triggering mania.
Has not demonstrated efficacy in treating acute mania.
1st line for patients w/ acute severe mania
Lithium or valproate
Dopamine antagonists
Haloperidol (haldol)
Chlorpromazine (thorazine)
Dopamine antagonist SE
Parkinsonian sx Dyskinesia Tardive dyskinesia Dysautonia DYstonia Akathisia
Cogentin
Relieves SE of dopamine antagonists.
Anticholinergic med
Serotonin-dopamine antagonists (SDAS)
Atypical antipsychotics
Second generation antipsychotics
Fewer SE
No extrapyramidal SE
SDAS SE
Weight gain
Glucose intolerance
DM
Hyperlipidemia
Clozapine brand name
Clozaril
SDAS
Weight gain
Olanzapine brand name
Zyprexa
SDAS
Weight gain
Ziprasidone brand name
Geodon
SDAS
Less weight gain
Risperidone brand name
RIsperidol
Which SDAS causes least weight gain?
Ziprasidone (Geodon)
Aripiprazole brand name
Abilify
Quetiapine brand name
Seriquel
Drowsiness
