CNS - Bipolar

Question 1

What is the Manic phase in bipolar?

Answer 1

Overactive and excitable

Question 2

What is the depressive phase in bipolar?

Answer 2

Lethargic and Reclusive

Question 3

Acute treatment for Bipolar?

Answer 3

• Benzodiazepines
• Antipsychotic drugs : ROQ

RISPERIDONE
OLANZAPINE
QUETIAPINE

Question 4

Prophylaxis Treatment for bipolar?

Answer 4

Sodium Valproate
Lithium
Carbamazepine

Question 5

Lithium therapeutic range?

Answer 5

0.4 - 1mmol/L

Question 6

Lithium Acute episodes range?

Answer 6

0.8 - 1mmol/L

Question 7

When to measure lithium after dose?

Answer 7

12 hours

Question 8

Monitoring how often?

Answer 8

Weekly till stable

Then 3 monthly for 1 year

Then 6 monthly so forth

Question 9

Lithium toxicity signs?

Answer 9

Renal Impairment - incontinence
Extrapyrimidal side effects - Tremors
Visual - blurred vision
Nervous system - confusion/restlessness
Gastrointestinal - Diarrhoea / Vomiting

Question 10

Lithium toxicity symptoms remember through which saying?

Answer 10

Tremor & Sick

***sick=N&V & diarrhoea

Question 11

Lithium side effects?

Answer 11

Thyroid disorders
Nephrotoxicity
Rhabdomyolysis
QT prolongation
Benign Intercranial hypertension
Teratogenic first trimester

Question 12

Why is it important to maintain good salt and fluid level when taking lithium?

Answer 12

Hyponatraemia can increase toxicity risk

Question 13

Lithium interactions?

Answer 13

Can cause Serotonin syndrome

Extrapyramidal side effect drugs eg Metoclopramide

Renally cleared drugs INCREASE toxicity risk

Reduced seizure thresholds

QT Prolongation drugs