Bipolar Drugs Flashcards
What drugs should not be used as sole treatment in bipolar disorder?
Antidepressants - can lead to manic episode
What is a unique benefit of lithium?
It reduces the risk of suicide in patients
What happens to Li+ levels with diuretics that act at the proximal tubule?
Li+ will decrease
What happens to Li+ levels with diuretics that act at the distal tubule?
Li+ will increase
For what kind of diuretics will the Li+ level remain normal?
Loop Diuretics
What does Na+ depletion do the Li+ level?
Increases it
Lithium SE
- Decreased thyroid function
- Increased parathyroid function
- Tremor
- Decreased concentration
- Sedation
- Weight gain - VERY slow
What is the therapeutic range of Li+ like?
Very narrow
What is the first line treatment for bipolar disorder?
Lithium
What are some of the difficulties with taking valproic acid?
High amount of GI side effects of diarrhea and nausea.
What is the difference between Depakote and valproic acid?
Depakote is a mix of valproic acid and sodium valproate that has less GI SE than valproic acid.
Depakote is highly _________ in the plasma.
Protein-bound
What hepatic enzymes does Depakote inhibit?
Phase II Glucoronidation - NOT CYP450
Depakote SE
- GI problems
- Tremor
- Sedation
- Weight gain
- Thrombocytopenia @ high doses
- Increased NH3
How does carbamazepine have DDIs?
Via the CYP450 system