Bipolar Disorders and AntiManic Drugs: 10 Flashcards
What is Mania?
Elevated, expansive, or irritable mood and
increased activity/energy for at least 1 week
Delineate clinical symptoms and diagnostic criteria of each classification of bipolar disorder (5)
Clinical Symptoms and Diagnostic criteria for BP1
What is required to be diagnosed with BP1?
At least 1 Manic Episode (lasts 7 days, less if hospitalized)
Major depressive episodes are common but not required for diagnoses
Mania Symptoms
DIG FAST and?
Distractibility ↑
Irresponsibility
Grandiosity ↑
Flight of Ideas
Activity increases ↑
Sleep decreases ↓
Talkativeness/pressured talke ↑
Marked impairment in functioning
Diagnostic criteria for BP2?
At least one hypomanic episode + major depressive episode
(required)
Hypomania: Elevated, expansive, or irritable mood and increased activity/energy for at least 4 days
Clinical Symptoms and Diagnostic criteria for Cyclothemia
Chronic fluctuating mood For at least?
Chronic fluctuating mood For at least 2 years, for at least 50% of the time, there have been multiple:
- Hypomanic symptoms without meeting full criteria
- Depressive episodes without meeting full criteria
Understand mechanism of action of antimanic drugs, common side effects, monitoring requirements, and adverse effects for these treatments (5)
Lithium
Theruputic range
Decreasing sodium will?
if you are dehydrated?
Should u drink water?
0.6-1.2
Increase lithium
If you are dehydrated, lithium levels increase
STAY HYDRATED!!!!
Side effects of LITHIUM?
1 more effect?
L evels (0.6-1.2 mEq/L)
I ncreased urination (polyuria)/ Insipidus
T remors/Thirst
H ypothyroidism
I nteractions (NSAIDS,ACE-Is,Diuretic, etc.)
U pset stomach
M uscle weakness/ Miscellaneous- EKG
changes)
G.I. adverse effects
Lithium toxicity: early elavated lithium
1.5-2
Coarse tremors
GI distress
Lithium toxicity: Elavated lithium
2-2.5
Extreme polyuria
Severe hypotension
Stupor/coma
VALPROIC ACID (Divalproex Sodium)
Side Effects?
Black box warning for?
Monitor?
STANT
Sedation
Tremor
Anorexia
N/V
Thrombocytopenia
Hepatotoxic, teratogenic, pancreatitis
Monitor LFT’S!!!!!!
CARBAMAZEPINE
may be effective if what fails?
Side effects?
Black box warning for? 2
may be effective if Lithium trial fails
Nystagmus
N/V
Dizziness
Drownsiness
Blurred vision
- Stevens-Johnson syndrome
- bone marrow suppression leading to anemia and agranulocytosis
CARBAMAZEPINE
Causes what and when should you take?
Due to bone marrow suppression check and report?
Due to SJS/TEN protect and report?
Causes drowsiness so take at night
Periodic checks of CBC
Report fever/sore throat
Protect skin from sun exposure
Report skin rash/mouth sores
LAMOTRIGINE
May be effective when?
Causes
Side effects?
Black box warning for?
May be effective when depressive episodes co-occur
Drownsiness!!!!
Diplopia
Dizziness
Headache
N/V
Stevens-Johnson syndrome
Lamotrigine nursing considerations
2
Due to SJS/TEN:
Protect skin from sun exposure
Report skin rash/mouth sores
CNS effects:
Use caution when driving
The visual disturbances should decrease over time
