Mania Flashcards
lithium also works on
headaches esp cluster headache
monotherapy with antidepressants in bipolar patients
can ppt mania
VD lithium
equal to body water, anything that reduces body water volume–>toxic
increase
increse in circulating lithium levels
toxicity/side effects lithium
biggest- nausea, weight gain
less common- nephrogenic Diabeties insipidus
tremor, cognitive slowing, drowsiness
interactions lithium
drugs that change tbw- diuretics, aceinhibitors, ca channel blcokers
pregnancy with lithium
risk factor D
black box warning lithium
very narrow therapeutic window- never double up
valproic acid class
anti-convulsant
pharmacodynamics valproic acid
increase GABA effects–>decrease glutamate/NMDA-mediated excitation, block channels
valproic acid/depakote side effects
potential for severe impact on liver
polycystic ovary syndrome
hair loss
black box warning depakote/valproic acid
hepatotoxicity
teratogen
pancreatitis
carbamazepine drug class
anticonvulsant for focal and secondary generalized seizures
mood stabilizer for BPD
pain mod for neuropathic pain
pharmacodynamics
Na channel sin neuron membrane decrease firing therefore decrease seizure
toxicity/side effects carbamazepine
drowsiness, headaches, migraines, motor coordination impairment and/or upset stomach, weight gain
aplstic anemia! derm skin problems
pregnancy carbamazepine
class D
lamotrigine drug class
anti-convulsant, mood stabilizer
lamotrigine is really good because
been show to act as a mood stabilizer and antidepressant- good to add to lithium with less weight gain
pharmacodynamics lamotrigine
unclear mechanisms- Na channel
toxicity/side effects of lamotrigine
serious skin rashes (toxic epidermal necrosis)
fever, fatigue, somnolence, vertigo, ataxia
interactions lamotrigine
fewer than any other!!
oxacarbezine class
anticonvulsant
pharmacodynamics
same as carbazepine- na channels, but with less side effects
toxicity of oxacarbazepine
all related to decraese Na levels
hypnatremia (test Na if severe fatigue)
special considerations oxacarbazepine
depression
behavior changes suicidality
combo of atypical antispychotic and lithium
better but weight gain and sedation make it unappealing
how to treat when mania decreases
taper off of atypical antipsychotic when mania decerases and effective and safe level of mood stabilizer in blood
