Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Lecture 10 - Bipolar Disorder > Flashcards

Lecture 10 - Bipolar Disorder Flashcards

1
Q

Drugs used for bipolar disorder?

A
  • lithium
  • valproate
  • lamotrigine
  • atypical antipsychotics
  • carbamazepine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the 3 parts to bipolar disorder

A
  • mania
  • hypomania
  • depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define mania

A
  • distinct period of dramatically elevated, irritable mood lasting 1 week or more and impairing social functioning
  • can include: inflated self-esteem, reduced need to sleep, verbosity, racing thoughts, distractibility, risky behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define hypomania

A
  • briefer duration of manic symptoms
  • less severe
  • no positive psychotic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bipolar is divided into:
Bipolar 1
Bipolar 2

Describe them

A

Bipolar 1:

  • episodes of sustained mania, usually with intervening depressive episodes
  • more mania

Bipolar 2:

  • major depressive episodes with at least 1 manic episode
  • more depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

___% of adults affected by bipolar in north america

A

1-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bipolar 1:

more common in males or females?

A

equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bipolar 1:

average onset

A

at 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bipolar 2:

more common in males or females?

A

females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Non-pharm treatments for bipolar disorder

A

adjust sleep, nutrition, exercise, stress, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pharmacological treatment for bipolar disorder

A

Mood stabilizers
-lithium, valproate, lomtrigine, carbamazepine
Atypical antipsychotics
Adjunct therapy with benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drugs are used to control manic episodes?

A 
lithium
carbamazepine
valproate
antipsychotics
benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How effective is lithium for a manic phase?

A

60-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How effective is lithium for maintenance?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Patients with mania possessing psychotic features often receive adjunct ??

A

SGA (olanzapine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much does lithium reduce suicide?

A

8-10 fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does lithium have a fast or slow onset of therapeutic effects?

A

slow onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the major working hypothesis for the mechanism of action for lithium?

A

Li+ affects the IP3/DAG second messenger system by blocking inositol recycling

19
Q

Early adverse effects of lithium

A
  • GI: nausea, vomitting, diarrhea
  • muscle weakness/ lethargy
  • polydypsia with polyuria/nocturia (excessive urination or urination at night)
  • headache, confusion, tremor
  • nephrogenic diabetes insipidus (fluid loss due to abnormal kidney fcn)
20
Q

Long-term adverse effects of lithium

A
  • renal morphology changes
  • hypothyroidism and/or goiter
  • weight gain > 10 kg
  • reduced libido/sexual dysfunction
  • edema
  • severe acne
  • cardiovascular
21
Q

List 3 other adverse effects of lithium

A

1 - low therapeutic index
2 - problematic in renal inusfficiency
3 - drug interactions

22
Q

Describe the drug interactions with Li+

A

1 - thiazide diuretics, NSAIDS, ACE inhibitors = increase Li

2 - K+-sparing diuretics = reduce Li

3 - loop diuretics, Ca channel blockers = may increase or decrease Li

23
Q

Carbamazepine is good for?

A

manic
depression
maintenece

*good for all 3 categories

24
Q

Carbamazepine is better than Li for ??

A

rapid cycling between the two phases

25
Q

Adverse effects of carbamazepine?

A 
nausea
vomiting
diarrhea
hyponatremia
rash
leukopenia
fluid retention
drowsiness
dizziness
lethargy
headache
26
Q

Valproate is approved for?

A

anti-manic effects

27
Q

Valproate:

strong efficacy in Patients not responsive to ___

A

Li

28
Q

Valproate:

better than Li for ??

A

rapid cycling between the two phases

29
Q

Valproate:

is generally well-tolerated but with upward dose titration - can cause?

A 
nausea
weight gain
diarrhea
vomiting
hair loss 
tremour
30
Q

Antipsychotics are used alone or with a ??

A

mood stabilizer

31
Q

Describe benzodiazepines

A
  • used with mood stabilizer
  • clonazepam is drug of choice
  • limited by abuse potential beyond acute setting
32
Q

What drugs control depressive episodes?

A
  • lithium
  • lamotrigine
  • antipsychotics
  • antidepressants
33
Q

Lamotrigine has ____ efficacy for mania

A

limited

34
Q

Lamotrigine has ___ control of depressive episodes

A

good

35
Q

Lamotrigine is an alternative to lithium for ?

A

maintenence

36
Q

Combination of antipsychotics is FDA approved for ?

A

bipolar depression

37
Q

Should you use antidepressants in a bipolar patient?

A

NO

  • no quantifiable advantage of mono therapy or combination therapy
  • monotherapy of antidepressants may precipitate “switch” to mania
38
Q

What drugs are used for maintenance therapy?

A 
lithium
lamotrigine
valproate
carbamazepine
\+psychotherapy
39
Q

Lifetime bipolar is diagnosed as ?

A

3 or more manic episodes or 1 moderate to severe manic episode

40
Q

Drug efficacy is assessed in 3 categories: what are they?

A

mania
depression
maintenance

41
Q

_____ is widely used and has efficacy in all 3 categories, but it is associated with therapeutic lag and considerable adverse effects

A

Lithium

42
Q

Alternatives to lithium for manic episodes

A

Valproate
Carbamazepine
SGAs
benzodiazepines

43
Q

Alternatives ot lithium for depressive episodes

A

Lamotrigine

SGAs

44
Q

Alternatives to lithium for maintenance therapy

A

Valproate
Carbamazepine
Lamotrigine

Pharmacology (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions