Bipolar Disorder Flashcards

1
Q

BP is classified as BP I and BP II, which differ primary by what?

A

the severity of mania

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2
Q

At least one episode of mania, and usually, bouts of intense depression (a depressive episode is not required for diagnosis)

A

Bipolar I

mania is associated with at least one of the following: significant impact in social or work functioning, psychosis or delusions or requires hospitalizations

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3
Q

At last one episode of hypomania (lasting >4 consecutive days) and at least one depressive episode last >2 weeks

A

Bipolar II

hypomania does NOT affect social or work functioning, does not cause psychosis nor hospitalization

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4
Q

How is mania diagnosed?

A

exhibits >3 symptoms

  • inflated self-esteem
  • needs less sleep
  • more talkative than normal
  • topic jumping
  • easily distracted
  • goal-directed activity inc
  • high-risk pleasure activities
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5
Q

What are the traditional mood stabilizers that treat both mania and depression?

A

lithium, valproate, lamotrigine, carbamazepine

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6
Q

These drugs can help stabilize the mood when mania occurs with psychosis

A

antipsychotics

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7
Q

these drugs can induce or exacerbate a mania episode when used as monotherapy, so they should only be used in combination with a mood stabilizer

A

antidepressants

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8
Q

What is the acute treatment for a manic episode?

A

first line: valproate, lithium or an antipsychotic

severe: antipsychotic+ (lithium or valproate)

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9
Q

Acute treatment for a depressive episode?

A

First line: lithium

alt: lamotrigine

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10
Q

Maintenance treatment?

A

should be initiated after the acute episode

lithium and valproate are preferred for maintenance monotherapy

alt: lamotrigine, carbamazepine, SGAs

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11
Q

What is required with all antidepressants and with all antipsychotics

A

medguides

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12
Q

Valproate

carbamazepine

and lithium in preg can cause

A

cognitive effects.

AVOID, esp in 1st trimester

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13
Q

What is the safer option in pregnancy?

A

lamotrigine.

Lurasidone has the most favorable safety profile in preg, but its use is limited for dipolar depression

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14
Q

Lamotrigine should not be used for

A

acute mania

slow titration

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15
Q

Lamictal

A

lamotrigine

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16
Q

Depakote, Depacon, Depakene

A

Valproate/Valproic acid

17
Q

Equetro

A

Carbamazepine

18
Q

What is the major concern with antipsychotics?

A

EPS

first-generation has a higher incidence than SGAs

19
Q

What are the more common SGAs that can be used alone or in combo with mood stabilizers for acute mania and or maintenance treatment

A
Abilify
Zyprexa
Seroquel
Risperdal
Geodon
20
Q

Brand: abilify

A

Generic: aripiprazole

21
Q

Brand: Zyprexa

A

Generic: Olanzapine

22
Q

Brand: Seroquel

A

Generic: Quetiapine

23
Q

Grand: Risperdal

A

Generic: Risperdone

24
Q

Brand: Geodon

A

Ziprasidone

25
This drug can be used alone or in combo with mood stabilizer for bipolar depressive episodes
lurasidone/latuda
26
Brand: Latuda
Generic: lurasidone
27
This drug works by influencing the reuptake of serotonin and or NE or by moderating glutamate levels in the brain
Lithium (Lithobid) could cause serotonin syndrome
28
What is the therapeutic range of lithium?
0.6-1.2mEq/L trough
29
This drug side effect profile: | GI upset, cognitive effects, cogwheel rigidity, hand tremor, thirst/polyuria/polydipsia, weight gain, hypothyyoidism
Lithium
30
Lithium toxicity level >1.5 could cause
ataxia, course hand tremor, vomiting
31
Lithium toxicity level >2.5 could cause
CNS depression, arrhythmia, seizure, coma
32
Lithium monitoring:
lithium levels, renal, thyroid function
33
This drug has drug interactions with: INC drug: sodium loss (ACE/ARBs) NSAIDs DEC drug: inc salt intake, caffeine
Lithium
34
5mL of lithium citrate syrup = ___ mEq of lithium ion
8mEq
35
8mEq of lithium ion = ___mg of lithium carbonate
300mg