Ch. 23 - Meds for bipolar disorders

Question 1

during a manic episode, lithium level should be what

Answer 1

0.8-1.4

Question 2

antiepileptic meds are particularly useful for cilents who have what two disorders

Answer 2

mixed mania

rapid-cycling bipolar

Question 3

antiepileptic meds for bipolar include

5

Answer 3

COLTV - carbs, ox, lamo, top, val

1. carbamazepine
2. oxcarbazepine
3. lamotrigine
4. topiramate
5. valproic acid

Question 4

lithium GI sx and interventions

Answer 4

nausea, diarrhea, abd pain

NI: educate that GI distress is transiet; take with meals or milk

Question 5

valproate - monitor what

Answer 5

AST/ALT and LDH due to risk for hepatotoxicity

Question 6

lithium - tinnitis

Answer 6

severe toxicity sign

Question 7

when should you administer antiepileptic meds

Answer 7

at bedtime

Question 8

carbamazepine is contraindicated in who

Answer 8

pt with bone marrow suppression or bleeding disorders

Question 9

lithium - decreased blood sodium levels

Answer 9

lithium excretion is decreased (increase of lithium in the blood)

Question 10

why give antipsychotics of bipolar

3

Answer 10

1. promote sleep
2. decrease anxiety and agitation
3. demonstrate mood stabilizing properties

Question 11

if pt is taking lithium, they should seek medical attention if the experience what three things

Answer 11

diarrhea
vomiting
excessive sweating

Question 12

anxiolytics for acute mania

2

Answer 12

clonazepam

lorazepam

Question 13

lithium therapeutic use in bipolar

3

Answer 13

1. controls episodes of acute mania
2. helps to prevent return of mania or depression
3. decreases incidence of suicie

Question 14

aminophylline use

Answer 14

can be used to treat severe toxicity of lithium, levels greater than 1.5

Question 15

lithium maintenance level

Answer 15

0.6-1.2

Question 16

polyuria is to

Answer 16

lithium toxicity

Question 17

blood dyscrasias (leukopenia, anemia, thrombocytopenia) is SE of

Answer 17

anti epileptics

Question 18

antiepileptic meds have a minimal effect on ___ function

Answer 18

cognitive

Question 19

lamotrigine side effects

5

Answer 19

double or blurred vision
dizziness
headache
nausea
vomiting

Question 20

diuretics (furosemide) and lithium

Answer 20

contraindicated together due to risk for toxicity

Question 21

lithium effect in the brain

Answer 21

serotonin receptor blockade

Question 22

lithium with NSAIDs

Answer 22

increases renal reabsorption of lithium (use aspirin instead)

Question 23

when can pt feel benefits from lithium

Answer 23

5-7 days but may take 2-3 weeks