Central Nervous System - Biopolar Disorder

Question 1

what is bipolar disorder

Answer 1

extreme fluctuation between maniac phases (overactive + excitability) + depressive phases (reclusive + lethargic)

Question 2

tx acute of bipolar disorder
1,2,3rd line

Answer 2

-benzodiazepines (lorazepam)
-antipyschotics (quetiapine, olanzapine/risperdone)
-> add lithium or sodium valproate

Question 3

tx prophylaxis of bipolar disorder

Answer 3

carbamazepine
lithium
sodium valproate

Question 4

prophylaxis tx of bipolar disorder

Answer 4

-carbamazepine, sodium valproate or lithium

Question 5

therapeutic range of lithium

Answer 5

0.4-1mmol/l

Question 6

therapeutic range of lithium in acute episodes

Answer 6

0.8-1mmol/l

Question 7

how often do you need to measure lithium levels

Answer 7

measure levels 12hr after each dose - weekly till stable then 3MT for 1YR * 6MT

Question 8

lithium toxicity signs

Answer 8

CUT-DVB
confusion + restlessness
urinary incontience
tremor
diarrhoea
vomiting
blurred vision

Question 9

lithium s/e

Answer 9

QT2-BNR
QT prolongation
thyroid function
tetragoenic
benign hypertension
nephrotoxicity
rhabdomylosis

Question 10

Lithium interactions

Answer 10

H2S3-EQR
Hypokalaemia
hyponatraemia
serotonin syndrome
salt imbalance
lower seizure threshold
extrapyramidal s/e
QT prolongation
renally cleared drugs ( high risk of toxicity)

Question 11

What are extrapyramidal S/E symptoms

Answer 11

inability to sit still
involuntary muscle contraction
tremors
stiff muscles
involuntary facial movements