Exam 2 Meds Flashcards

Question

Depakote Uncommon &severe Side effects

Answer 1

Uncommon Serious Side Effects • toxicity, severe anorexia, weight loss, vomiting, lethargy, jaundice, edema Abnormal liver function tests that leads to: Hepatic failure and contributes to liver • Platelet dysfunction (reversible): a classic sign aside from bleeding, is a sore throat with no fever • Pancreatitis….how do we know.. • Serum amylase. An increase of amylase in the blood usually indicates pancreatitis. • Serum lipase blood.. Sudden (acute) pancreatitis almost always raises the level of lipase in the CBC • The number of white blood cells rises in pancreatitis, sometimes • aminotransferase Liver function tests. Increases in liver enzymes, particularly of ALT, and alkaline phosphatase.alanine • Bilirubin. The level of bilirubin in the blood may increase. Rare Dangerous Side Effects • Bone Marrow Suppression • Neutropenia • Endocrine abnormalities • Amenorrhea, polycystic ovarian syndrome • Hypothyroidism • Hypocortisolemia

Answer 2

SSRI use may increase depakote levels • Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Cardiovascular malformations, genitalanomalies, intrauterine growth retardation, limb defects, hydrocephalus, pulmonary atresia

Answer 3

• Used to treat Acute mania • Prevention of bipolar disorder • Treatment refractory depression • Complex seizures • Better for rapid cycling and mixed mania • Schizoaffective Disorder • PTSD • Episodic dyscontrol • Onset 2 weeks, antidepressant 4-6 week • Approved by the FDA for the treatment of manic episodes in an extended release form called Equetro • Therapeutic Blood Level = 4-12mEq/L

Answer 4

Common Side Effects -Sedation, nausea -Drowsiness -Rash -Dizziness -Clumsiness -Ataxia: usually means dosage is too high -Double or blurred vision Uncommon Side Effects • Stevens-Johnson Syndrome: usually when med is titrated too quickly - a system ic skin disease, fever, oral lesions- can lead to death • Bone marrow depression • Serious decrease of WBCʼs, RBCʼs, platelets • Liver failure • Bradycardia, Heart Block • Less weight gain, hair loss, trem or than VPA

Answer 5

Monitor for fever, sore throat, pallor, petechiae, easy bruising • Suggest CBC • Use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester iscontraindicated. Increased risk for craniofacial abnormalities, fingernail hypoplasia, developmental delay growth retardation, microcephaly, spinabifida, and cardiac abnormalities

Answer 6

VPA, Lamotrigine, TCAs, Prednisone, Theophylline,Warfarin, Benzos, & oral contraceptives • Ca-channel Blockers, Erythromycin, Fluoxetine, Isoniazid, Novel Anticonvulsants

Answer 7

-FDA approved for rapid cycling relapse prevention • Trileptal – Oxcarbazepine

Answer 8

• Close cousin of Tegretol (Carbamazepine) • Free from most of the problems associated with Tegretol • May cause fatigue and dizziness but milder • Only laboratory monitoring necessary is Sodium levels during the first 3 months • 2.5% of patients will develop hyponatremia.

Answer 9

• Approved for migraines and epilepsy • Off label for Bipolar Disorder • Used as an adjunctive medication in mania, hypomania, and mixed episodes • Side Effects Weight loss • Sedation • Memory loss • Confusion Sometimes referred to Dopamax Kidney stones 1-2% Can decrease levels of oral contraceptives

Answer 10

• Approved for epilepsy neuralgia • Previously illegally marketed for bipolar and other uses (WarnerLambert guilty) • Useless for Bipolar Disorder • Sometimes used for anxiety or insomnia • Results of studies not that impressive • Benzodiazepines • They are sedating • Helpful for agitation and psychosis of mania

Answer 11

-An antipsychotic drug approved to treat depressive episodes in adults with bipolar Ior II disorder. Side effects somnolence/sedation, nausea, dizziness, and dry mouth. Neonates in thirdtrimester are at risk for EPS and/or withdrawal after delivery. Reduce dosage in patients with moderate tosevere hepatic impairment to 21 mg. Strenuous exercise, excessive heat, dehydration and use ofanticholinergic medications can increase core body temperature.

Answer 12

treat bipolar I disorder and schizophrenia inadults. Common possible side effects include weight gain, dry mouth, headache, constipation,increased appetite, dizziness.samidorphan, attaches to opioid receptors in the brain and can “kickoff” opioids that are already attached to these receptors. If there are still opioids present in the body,this may trigger an opioid withdrawal.

Answer 13

-tends to have effects of akathisia with little to no effects on metabolic parameters •Used as adjunct in depressive episodes