Chapter 13: Bipolar & Related Disorders Flashcards
What is the only medication on the market that is classified as mood stabilizer
lithium
If not a mood stabilizer, the other mood related medications are classified as
anticonvulsants
Bipolar 1 and 2 are defined by:
the pt’s level of mania
Bipolar 1 is characterized by
High mania, low depression. Hospitalization usually caused by high mania episodes
Most severe form
Highest mortality rate of the three
Characterized by At least 1 manic episode
affects males more
Bipolar 2 is characterized by
Hypomania (high functioning) low depression. Hospitalization usually caused by extreme depression. Sometimes difficult to dx because mania seems more obvious and become labeled as a erratic personality.
Ask when/how depression occurs. Periods of feeling particularly good? If so, how long does it last? Does it surround depressive episodes? Do your antidepressants work?
characterized by At least 1 hypomanic episode
At least 1 major depressive episode
affects females more
T/F: You can tell if a pt is bipolar after just one interaction
F: Bipolar is dx over a long period, not day by day
How do you tell the difference between psychosis and mania?
psychosis doesn’t go away w/ out treatment. Mania is episodic and will go away.
Key traits of a pt in the midst of a manic episode
Manipulative
Demanding
Impulsivity
Grandiosity
What are the 2 Sx things you are trying to treat pharmacologically
Agitation
Mood stabilization
Describe the pharmacology of lithium
Therapeutic blood level: 0.8 to 1.4 mEq/L
Maintenance blood level: 0.4 to 1.3 mEq/L
Toxic blood level: 1.5 mEq/L and above
contraindicated for liver pts
check ati
Lithium carbonate
Indications
Therapeutic and toxic levels
Maintenance therapy
Contraindications
3 other mood stabilizers (anticonvulsants)
divalproex sodium/Valproate (Depakote)
Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
stephen johnsons: systemic anaphalaxis skin sloughs off
