Bipolar Quiz Flashcards
Which statement is correct?
A) Tremor is the most common adverse effect of lithium, and is seen only at high doses
B) Lithium clearance depends on GFR. Lithium should be used with caution in patients with renal impairment or renal disease; dosage reductions are recommended. Adequate fluid intake and maintenance of salt balance are essential during lithium therapy. Diuretics, ACEi, and ARBs should be used cautiously.
C) Lithium serum concentrations should be measured one hour after a dose is administered
D) Lithium acts by activating the inositol and glycogen synthase (GSK-3) signaling pathways.
B
Which agent should not be used for treatment or prevention of recurrence of bipolar disorder?
A) Gabapentin
B) Lithium
C) Valproic acid
D) Carbamazepine
A
Name two medications that should be used very cautiously in patients who are managed with lithium
ACEs and ARBs (losartan) – lithium has adverse effects on the kidney (losartan)
HCTZ
Methylphenidate MOA
Enhances DA by blocking DAT
Amphetamine MOA
Stimulates NE, DA, and serotonin release
Glaucoma
An absolute contraindicate to methylphenidate or amphetamine use bc they increase IOP
Atomoxetine
Inhibits NE reuptake
(THINK: tom is a loner so he only interacts with NE)
What is the idea behind the mechanism of ADHD drugs?
ADHD results d/t a dopamine deficiency
What is the half life on lithium?
20 hours
What are the major adverse effects of lithium use during pregnancy?
Congenital cardiac malformations, specifically Ebstein’s anomaly
Neural tube defects
Maternal preeclampsia, polyhydroamnios, floppy infant syndrome, preterm bith, low apgar score
Which agent used to managed BPD is most likely to decrease thyroid function?
Lithium
Lithium is an alternative to _______ for prophylaxis of ________ (type of headache)
Verapamil; cluster headache
