Bipolar Pharm Flashcards
drugs that reduce activity of what neurotransmitters relieve mania?
dopamine or noepinephrine
drug class that exacerbates mania in bipolar disorder
SSRIs
Name the three mood stabilizing agents
Lithium. Valproate (Depakote). Carbamazepine (Tegretol)
Medication that significantly decreases the frequency and severity of both manic and depressive episodes in about 70% of patients
lithium
May decrease norepinephrine and dopamine turnover. May augment the synthesis of acetylcholine, by increasing cholamine uptake into nerve terminals
lithium
Adverse effects include: tremor, edema, weight gain, decreased thyroid fxn
lithium
Side effect profile less than that of Lithium. Quick onset. May increase dose more rapidly
Valproate (Depakote)
Labs to check with valproate (Depakote)
LFTs and platelets
Comparable efficacy to Lithium. therapeutic window is 3-14. SE includes Steven’s Johnsons
Carbamazapine (Tegretol)
Treats bipolar depression without triggering mania, hypomania, mixed states, or rapid cycling. It has not demonstrated efficacy in the treatment of acute mania.
Lamotrigine (Lamictal)
first-line treatment for acute depression in bipolar disorder as well as a maintenance therapy
lamotrigine (Lamictal)
Name the first Generation Antipsychotics (DOPAMINE ANTAGONISTS)
Haloperidol (Haldol) and Chlorpromazine (Thorazine)
Effective in the treatment of schizophrenia, especially the positive symptoms
Haloperidol (Haldol) and Chlorpromazine (Thorazine)
Adverse effects include: akathisia, rigidity, tremor, tardive dyskinesia, and neuroleptic malignant syndrome
1st gen antipsychotics-Haloperidol (Haldol) and Chlorpromazine (Thorazine)
occurs after long-term treatment with an antipsychotic medication. Sometimes, this condition may become permanent
tardive dyskinesia
movement disorders including any of a number of repetitive, involuntary, and purposeless body or facial movements
dyskinesia
an extreme form of internal or external restlessness
akathisia
a muscle tension disorder involving very strong muscle contractions
dystonia
chiefly found in the reticular formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control
extrapyramidal tracts
anticholinergic medication. helps to re-establish a normal balance between dopamine and acetylcholine
cogentin
Interact with different subtypes of dopamine receptors than standard antipsychotics. Produce fewer neurological and endocrine side effects
Serotonin-Dopamine antagonists (Second Generation Antipsychotics; atypicals)
Effective in treating negative symptoms (such as withdrawal) in addition to the positive symptoms.
Effective for a broader range of patients
Cause very few, if any, extrapyramidal side effects
Serotonin-Dopamine antagonists (Second Generation Antipsychotics; atypicals)
Side effects of Serotonin-Dopamine antagonists (Second Generation Antipsychotics; atypicals)
weight gain, glucose intolerance, DM, hyperlipidemia
Atypical antipsycotic with side effect of agranulocytosis
Clozapine (Clozaril)
Atypical antipsycotic approved for treatment of a manic or mixed episode. also used for maintenance treatment after a severe or sudden episode
Aripiprazole (Abilify)
Atypical antipsychotic associated with drowsiness
Quetiapine (Seroquel)
1st line therapy for acute depression in patients with bipolar disorder
Lithium or Lamotrigin (Lamictal)
