CNS bipolar

Question 1

what is bpd

Answer 1

extreme fluctuation between manic and depressive phases

Question 2

tx for acute bpd

Answer 2

Benzodiazepine (Lorazepam) helps w/ initial symptoms

Antipsyschotics (ROQ- Risperidone, Olanzapine, Quetiapine) L? + in Lithium OR Sodium Valproate

Question 3

why are benzos not ideal for long term bpd tx

Answer 3

dependence

Question 4

bpd prophylaxis tx (CSL)

Answer 4

Carbamazepine
Sodium Valproate
Lithium

Question 5

lithium therap range

Answer 5

0.4-1.0mmol/L
normal for every day

Question 6

lithium THERAPEUTIC RANGE for ACUTE EPISODE TARGET?

Answer 6

acute episodes/relapse/sub-syndromal symptoms
0.8-1.0mmol/L

Question 7

when to measure lithium levels

Answer 7

12 hours after a dose
Weekly till stable-> 3 months for year 1-> 6months after that

Question 8

key features of Li tox (SICK AND TREMOR)
REVeNGe

Answer 8

Renal Impairment- incontinence
Extrapyramidal- tremor
Visual- blurred vision
Nervous System Disorder- confusion+restlessness
GI Disorder- D&V

Question 9

LITHIUM- SIDE EFFCETS?

Answer 9

Thyroid disorder
Nephrotoxicity
Rhabdomyolysis
QT prolongation
Benign Intercranial Hypertension (persistent headache and visual disturbance)
1st Trimester- teratogenic

Question 10

if pt on lithium has headaches, can potentially be what?

Answer 10

benign intercranial htn

Question 11

on Li, must maintain good dalt and fluid intake else hyponatraemia inc risk of what

Answer 11

toxicity - diuretics

any drugs that cause hypOnatraemia or affect kidneys will interact w li

Question 12

ses of Li

Answer 12

Salt Imbalance
Serotonin Syndrome (SSRIs, Tramadol)
Extrapyramidal S-E (Antiemetics, Antipsychotics)
QT Prolongation (Macrolides)
Renally Cleared Drugs (NSAIDs, ACEi)
Reduced Seizure Threshold (Tramadol)
Hypokalaemia (diuretics (loop/thiazide), insulin, laxative)
on Li