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Pharm ATI > Ch 9- bipolar disorders > Flashcards

Ch 9- bipolar disorders Flashcards

1
Q

Lithium carbonate purpose

A

Mood stabilizer

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2
Q

Lithium carbonate adverse effects

A 
GI distress
Fine hand tremors
Polyuria, mild thirst
Weight gain
Renal toxicity
Goiter and hypothyroidism (w/long term)
Bradydysrythmia
Electrolyte imbalance
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3
Q

Lithium less than 1.5

A 
Diarrhea
Nausea
Vomiting 
Thirst
Polyuria 
Muscle weakness
Fine hand tremor 
Slurred speech
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4
Q

Lithium 1.5-2

A 
Nausea
Vomiting
Diarrhea 
Mental confusion
Poor coordination
Coarse tremors
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5
Q

Lithium 2-2.5

A 
Extreme polyuria
Blurred vision
Ataxia 
Seizures 
Severe hypotension 
Coma
Death

Intervention: give alert patients emetic
Perform gastric lavage or admin mannitol or aminophylline to increase excretion

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6
Q

Lithium greater than 2.5

A

Rapid progression of symptoms
Coma
Death

Intervention: Hemodialysis

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7
Q

Lithium interactions

A

Reduces serum sodium decrease lithium excretion = toxicity

NSAIDs lead to toxicity

Anticholinergics (antihistamines , tricyclic antidepressants) induce urinary retention and polyuria

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8
Q

Nursing admin lithium

A

Monitor levels 2-3 days then every 2-3 mo

Obtain in morning

12 hrs after last dose

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9
Q

Initial treatment lithium level

A

.8-1.4

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10
Q

Maintain lithium level

A

.4-1

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11
Q

Plasma toxicity

A

> 1.5

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12
Q

Antiepileptic drugs (AEDs)

A

Carbamazepine (Tegretol, Equetro)

Valproic acid (Depakote)

Lamotrigine (Lamictal)

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13
Q

Carbamazepine adverse effects

A

CNS effects

Blood dyscrasias (leukopenia, anemia, thrombocytopenia)

Teratogenesis (avoid during preg)

Hypo osmolarity -fluid overload

Skin disorders (dermatitis, rash, Stevens Johnson’s)

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14
Q

Lamotrigine

A 
Blurred vision
Dizziness
Headache
Nausea
Vomiting

Stevens Johnson’s

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15
Q

Valproic acid adverse effects

A 
GI
Hepatotoxicity
Pancreatitis 
Thrombocytopenia
Teratogenesis
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16
Q

Carbamazepine interactions

A

Decrease effects of BC and warfarin

Grapefruit juice inhibits metabolism increasing levels

Phenytoin and phenobarbital decrease effects

17
Q

Lamotrigine interactions

A

Carbamazepine
Phenytoin
Phenobarbital

> decrease effects

Valproic acids increase half life

18
Q

Valproic acid interactions

A

Concurrent use increases levels of phenytoin and phenobarbital

19
Q

Lithium carbonate teaching

A

Increase fluids

Increase sodium

Take with food or milk

*thyroid function assessed periodically

Avoid aerobic activity in hot water (sodium water depletion)

Avoid NSAIDs (take acetaminophen)

Avoid during pregnancy

20
Q

Valproic acid tests

A

Thrombocyte count

Amylase

Liver function

Pharm ATI (17 decks)

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