Bipolar Disorder

Question 1

Lithium

Answer 1

To control MANIC EPISODES: mood stabilizer.
blood levels must be monitored frequently!
take WITH MEALS to reduce GI upset;
therapeutic after 1-2 weeks.

During depressive stages, dose is usually HALVED
Should have fluid intake of 2500-3000 ml per day and ADEQUATE SALT

Question 2

Lithium side effects

Answer 2

dizziness, headache, impaired vision, fine hand tremors and REVERSIBLE leukocytosis

Question 3

Lithium monitoring and TOXICITY

Answer 3

normal blood target level: 1-1.5!! VERY SLIM
signs of intox: vomiting, diarrhea, drowsiness, muscular weakness and ataxia
Check levels 2-3 times weekly when starting, draw in AM PRIOR TO DOSE; draw monthly while on maintenance.

Question 4

Carbamazepine

Answer 4

Mood stabilizer; traditionally for seizure and Trigeminal neuralgia
Shake oral suspension well before delivering dose; must have baseline URINALYSIS, BUN/Cr, LFTs and CBC
take with food! Ng tube? mix with equal parts water, then flush with 100 cc after dose

Question 5

Carbamazepine side effects

Answer 5

dizziness, vertigo, drowsiness - usually disappears in 3-4 days; ataxia, CHF, aplastic anemia, thrombocytopenia!

Question 6

aplastic anemia

Answer 6

plastic = new. your body stops producing enough RBCs

Question 7

Divalproex sodium

Answer 7

mood stabilizer, traditionally used for seizures! must get PLATELET COUNT BEFORE STARTING MED! also monitor LFTs and platelets while taking this med.
Take with FOOD OR MILK and AVOID HAZARDOUS ACTIVITIES! …

Question 8

Divalproex sodium side effects

Answer 8

sedation, PANCREATITIS, indigestion, THROMBOCYTOPENIA, toxic hepatitis - what are s/s of liver dysfn.? Malaise, fever, lethargy. (think: hangover)

Question 9

Overall action of meds for bipolar d/o

Answer 9

reduces amount of catecholamine released into synapse and increases reuptake of norepi and serotonin from synaptic space; competes with Na+ and K+ transport in nerve and muscle cells