Bipolar disorder Flashcards
What is bipolar disorder?
Bipolar disorder is a mental health condition that causes extreme mood swings.
What are the symptoms of bipolar disorder?
The main symptoms of bipolar disorder are episodes of extreme highs and lows, which can last for several weeks.
Mania.
Depression.
Hypomania.
What is bipolar I?
At least one manic episode needed for diagnosis. Major depressive episodes are typical, but not needed for diagnosis.
Bipolar I affects men and women equally.
What is bipolar II?
Bipolar II disorder is characterised by one or more major depressive episodes and by at least one hypomanic episode, but no evidence of mania.
What are the treatment options?
Physiological Interventions:
Family intervention.
Group intervention.
Structured individual intervention.
Pharmacological:
Antipsychotics.
Benzodiazepines.
Mood stabilisers.
Antidepressants.
What is aripiprazole?
Aripiprazole is a dopamine D2 partial agonist with weak 5-HT1a partial agonism and 5-HT2A receptor antagonism.
It is an atypical antipsychotic
What is olanzapine?
This is an atypical antipsychotic.
Doses in first episode psychosis are generally lower.
What is haloperidol?
This is a typical antipsychotic.
What is rapid tranquillisation?
Refers to the use of medication to calm highly agitated individuals experiencing mental disorder who have not responded to non-pharmacological approaches.
What is quetiapine?
This is an atypical antipsychotic.
Available as tablets and liquid.
Also available as long acting and short acting tablets (MR)
What is risperidone?
This is an atypical antipsychotic.
What is a mood stabiliser?
A mood stabiliser is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, such as bipolar disorder and the bipolar type of schizoaffective disorder.
What are some examples of mood stabilisers?
Sodium Valproate.
Lithium.
Carbamazepine.
Lamotrogine.
What are the types of sodium valporate available?
Epilim.
Depakote.
Pregnancy prevention programme.
What should the pharmacist consider when giving pregnancy prevention programme?
Pharmacist must ensure whole packs are dispensed whenever possible.
All packs should have a warning or a sticker.
Must discuss risks and ensure that patients have a patient guide.
Must check that patients are ware of need for contraception.
What clinical monitoring must be carried out for sodium valproate?
Liver function tests.
Vitamin D supplementation.
What clinical monitoring must be carried out for lithium?
Lithium level 5 days after first administration.
5 days after each dose change.
Every 3 months.
U and E, TFT every 6 months.
Levels if toxicity is suspected.
What are the side effects and interactions of lithium?
Side effects:
Metallic taste.
Thirst.
Tremor.
Interactions:
NSAIDS .
Ace inhibitors.
Low salt diet.
What is carbamazepine?
Licensed for prophylaxis of bipolar disorder unresponsive to Lithium.
Does not require any additional monitoring except manufacture suggest monitoring LFT and WBC
What is lamotrigine?
Licensed for use in epilepsy or bipolar disorder.
No therapeutic drug monitoring needed.
Doses must be titrated gradually to reduce risk of Steven Johnson syndrome.
When should antidepressants be used?
SSRIs are drugs of choice.
Used for short time - different to unipolar depression.
Prescribed alongside mood stabilisers.
How would you treat depression?
Use antidepressants for the shortest time possible.
Consider using a mood stabiliser in combination with an antipsychotic licensed for prevention of mania.
