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Pharmacology NURS 362 > Exam 1: Bipolar Disorder > Flashcards

Exam 1: Bipolar Disorder Flashcards

1
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
MOA:

A
  • Inorganic ion
  • Short T1/2 ~ 24hrs
  • Rapid absorption by GI →Excreted by kidneys
  • Exact MOA unknown
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2
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Indications:

A
  • if Severe mania → combine w/ antipsychotic
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3
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Contraindications:

A
  • *REQUIRES NORMAL SODIUM LEVELS
  • Water, kidneys
  • avoid w/significant renal dx
  • avoid 1st trimester pregnancy
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4
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Side effects:

A 
**Long-term trmt → ↓ SI w/0.8-1.2 mEq/L (normal)
• N/V/D
• Thirst
• Polyuria (50-70%)
• Lethargy
• Slurred speech
• Muscle Weakness
• Fine hand tremor
• Renal Damage
• Hypothyroid (over time) 
• Teratogenesis
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5
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Toxicity/AE:

A
  1. 5-2.0
    - GI upset
    - Coarse hand tremor
    - Confusion
    - Muscle hyperirritability
    - ECG changes
    - Sedation
    - Clumsiness
  2. 0-2.5
    - Ataxia
    - Giddiness
    - Dilute polyuria
    - ECG changes
    - Tinnitus
    - Blurred vision
    - Sz
    - Stupor
    - Hypotension
    - Coma
    - Death

> 2.5

  • Rapid progression to generalized convulsions
  • Oliguria
  • Death
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6
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Interactions:

A

Dehydration → ↑ drug levels

↑Na+ intake→ ↑ Na+ & Li+ excretion → ↓ Li+ levels

↓ Na+ intake → ↑ Na+ & Li+ reabsoption → ↑ Li+ levels

**caution w/deyhdration + diuretics

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7
Q

Class: mood stabilizers
Drug: Lithium (Lithonate, Lithotabs)
Route/dosing:

A
  • *5-7 days for effect
  • May need benzos/antipsychotic to bridge therapy
  • Start = 2-3 doses per day
  • Titrated ↑ → serum drug levels of 0.8-1.2mEQ/L
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8
Q

Class: Benzodiazepines
Drugs:

A
  • diazepam (Valium)
  • lorazepam (Ativan)
  • alprazolam (Xanax)
  • midazolam (Versed)
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9
Q

Class: Benzodiazepines
MOA:

A
  • Binds to GABA receptors
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10
Q

Class: Benzodiazepines
Indications:

A

**DOC → insomnia + anxiety
↓ptl for abuse
- general anesthesia
- acute sz mgmt

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11
Q

Class: Benzodiazepines

Side effects:

A

↓CNS

  • amnesia
  • sleep driving
  • respiratory depression
  • *stop if cannot recall events
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12
Q

Class: Benzodiazepines

Toxicity/AE:

A

IV Toxicity → ↓BP
**Respiratory + cardiac arrest

**taper slowly to avoid withdrawal

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13
Q

Class: Benzodiazepines
Interactions:

A
  • ETOH
  • Opioids
  • Barbiturates
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14
Q

Class: Benzodiazepines

Route/Dosing:

A

**REVERSED W/ FLUMAZENIL - Benzo-GABA receptor
ANTAGONIST
- May not reverse respiratory depression

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15
Q

Class: Benzodiazepine-like drugs/Sedative Hypnotic
Drugs:

A
  • zolpidem (Ambien)
  • zaleplon (Sonata)
  • eszopiclone (Lunesta)
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16
Q

Class: Benzodiazepine-like drugs/Sedative Hypnotic
Indications:

A

**most widely used HYPNOTIC
- insomnia
↓ risk tolerance / dependence / abuse

17
Q

Class: Benzodiazepine-like drugs/Sedative Hypnotic

Side effects:

A
  • daytime drowsiness

- dizziness

18
Q

Class: Barbiturates
Drug: phenobarbital (long-acting)
Indications:

A
  • Sz d/o
  • Anesthesia
  • Insomnia
  • CNS depressant
19
Q

Class: Barbiturates
Drug: phenobarbital (long-acting)
Side effects:

A

↓R

  • SI
  • Abuse
20
Q

Class: CNS stimulants
Drugs:

A
  • methylphenidate (Ritalin, Concerta)
  • dextroamphetamine
  • amphetamine mixture (Adderall)
21
Q

Class: CNS stimulants
MOA:

A

↑ activity CNS neurons

22
Q

Class: CNS stimulants

Side effects:

A
  • HA
  • Insomnia
  • Growth suppression - Lethargy
  • Listlessness
  • Irritability
  • Poor appetite
  • Weight loss
  • tics
23
Q

Class: CNS stimulants

Toxicity/AE:

A
  • Convulsions w/enough drug
24
Q

Class: CNS stimulants

Route/dosing:

A
  • *tolerance can develop w/regular use
  • *chronic use -→physical dependence
  • *withdrawal w/abrupt dc

Pharmacology NURS 362 (6 decks)

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