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Board Review > bipolarFC > Flashcards

bipolarFC Flashcards

1
Q

What monitoring for Lithium?

A

CBC (plasma levels), Renal (Renal changes over time-Nephrotoxicity), Thyroid (Decreased thyroids function over time)

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2
Q

What initial side effects do you see with the use of Lithium?

A

GI distress, fine hand tremor, Inability to concentrate urine.

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3
Q

What agent is useful in lithium-refractory patients, rapid cycling and mixed episodes, as well as useful in acute mania, with efficacy close to lithium?

A

Carbemazepine

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4
Q

This agent is more effective than lithium in controlling rapid cycling, mixed statesm and comorbid substance abuse, and is often used in combination with lithium to treat refractory rapid cycling and mixed states?

A

VPA

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5
Q

Bipolar 1 is characterized by what types of episodes predominately?

A

Manic

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6
Q

Bipolar 2 is characterized by what types of episodes predominately?

A

Depressive

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7
Q

Approximately how many percent of bipolar patients discontinue pharmacological therapy?

A

50

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8
Q

How many months must pass for a patient to be in remission?

A

6

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9
Q

What is the preferred agent for treating euphoric mania?

A

Lithium

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10
Q

What is the preferred agent used for treatment of irritable mania, mixed, rapid cycling episodes?

A

Divalproex Sodium

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11
Q

What agent must be scheduled for acute episodes of mania, and DCed after symptoms begin to respond?

A

CBZ, OXC

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12
Q

Which agent is in a sublingual twice daily dose that requires the patient to not drink or eat for 10 minutes after administration?

A

Asenapine (Saphris)

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13
Q

What is used for the treatment of psychotic mania, and aggression?

A

Antipsychotics

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14
Q

What are the antipsychotics used in acute mania?

A

Aripiprazole, Olanzapine, Quetiapine, Risperidone, Ziprasodone

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15
Q

What antipsychotic is used for refractory cases (more than 2 agents tried) of acute mania?

A

Clozapine

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16
Q

What is the severe SE associated with Clozapine?

A

Agranulocytosis

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17
Q

What are the common side effects of antipsychotics?

A

Weight gain, Sedation, Diabetes, metabolic syndrome

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18
Q

At what level of lithium will a patient be needed to put on dialysis?

A

2

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19
Q

What is the normal level range of lithium?

A

0.8 - 1

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20
Q

What is the therapeutic level range of Divalproex Sodium?

A

50-125

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21
Q

What are the characteristic side effects of Divalproex sodium?

A

Hyperammonia, Hypothyroid, and Thrombocytopenia

22
Q

What is the only antipsychotic available that you can use as a monotherapy for depression?

A

Quetiapine

23
Q

What is the common SE profile of second generation antipsychotics?

A

Movement disorders, sedation, orthostatic hypotension, Constipation, Metabolic syndrome

24
Q

What are the FDA approved agents used in pediatric mania?

A

Risperidone, Aripiprazole

25
Q

What are the preferred first line agents for an acute depressive episode?

A

Lithium, Quetiapine

26
Q

What is the characteristic side effect associated with Lamotrigine (Lamictal)?

A

SJS-Rash

27
Q

What woud you add to a lithium treatment if a patient is having a psychotic depression?

A

Lamotrigine, divalproex sodium

28
Q

Which agent’s dose needs to be halved when taking with VPA?

A

Lamotrigine

29
Q

What benzo can be used in refractory cases of depression?

A

Carbemazepine

30
Q

What is the preferred class of antidepressants?

A

SSRI

31
Q

What is the most common side effect of Olanzapine (Zyprexa)?

A

Weight gain

32
Q

What is the most common side effect of Quetiapine (Seroquel)?

A

Sedation

33
Q

What is the most common side effect of Risperidone (Risperdal)?

A

EPS

34
Q

What is the most common side effect of Ziprasidone (Geodon)?

A

QT prolongation

35
Q

Which adjunct agent is useful in concomitant anxiety or pain conditions?

A

Gabapentin, Pregbalin

36
Q

Which bipolar agent is the only agent that requires thyroid function monitoring?

A

Lithium

37
Q

What monitoring parameters are needed for Divalproex sodium?

A

LFT< CBC

38
Q

What monitoring parameters are needed for Lamotrigine?

A

none, look out for SJS-rash

39
Q

What monitoring parameters are needed for CBZ?

A

CMP, LFT, CBC

40
Q

What monitoring parameters are needed for OXC?

A

CMP, LFT

41
Q

depakene

A

valproate

42
Q

stavzor

A

valproate

43
Q

depacon

A

valproate

44
Q

depakote

A

divalproex

45
Q

lamictal

A

amotricgine

46
Q

lithobid

A

lithium

47
Q

abilify

A

aripiprazol

48
Q

seroquel

A

quetiapine

49
Q

symbyax

A

olanzapine/fluoxetine

50
Q

ripserdal

A

risperadone

51
Q

geodone

A

ziprasadone

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