Bipolar Disorder Meds Flashcards
Depakote
Divalproex sodium delayed release:
BBW: liver tox, pancreatitis
Stavzor
Valproic acid ER: epilepsy, manic episodes & migraine ppx
Zyprexa
Olanzapine (SGA) monotherapy for Bipolar
10mg IM for acute mania
Equetro
Carbamazepine
SE: aplastic anemia, agranulocytosi
Lamictal
Lamotrigine
SE: life-threatnening RASH, d/c on first sign of rash, do not re-challenge
Risperdal
Risperidone: bioplar, schizo, PTSD & Tourettes (unlabeled), irritability w/ autistic disorder
Geodon
Ziprasidone: acute mania or mixed episodes
Eskalith, Lithobid (SR)
Lithium: alter cation, NE, 5HTs transport
For: bipolar & depressive disorder
Effect: usually in 1 wk, full effect: 2-3 wks
Lithium Side Effects
GI: N/V/D (divided doses w/ meal to avoid it)
Fine intentional hand tremor (tx: propanolol)
Polyuria/polydipsia
Lithium Dosage
300-600 mg BID-TID, effect range: 900-1800 mg/d
Elderly & renal impair: 300 mg/d & level: 0.4-0.6 mmol/L (important)
Acute level: 0.8-1.5meq/L
Maintenance: 0.6-1.2meq/L
Draw level just before next dose after 5 days of treatment
Lithium Toxicity
> 1.5 MEq/L, S/Sx: coarse hand tremor, vomiting, diarrhea, confusion, ataxia, slurred speed, & lethargy
2 MEq/L: profound CNS depression, arrhythmia, seizures & coma (NS infusion or hemodialysis)
Lithium Late Side Effects
Late effect: Nephrogenic Diabetic Insipidus (avoid dehydration) Leukocytosis (WBCs) Hypothyroidism (constipation) Wt gain Acne & alopecia Bradycardia
Lithium Drug Interactions
Increase Lithium (Diuretic, NSAID, ACEIs), ASA & clinoril (sulindac) have no DDI Decrease Lithium (preg, NaCl)
Lithium Labs & Monitoring
BUN/SCr Urine Specific gravity CBC Electrolytes: hyponatremia, hypokalemia TSH EKG Glucose
