Module 1 & 2 Flashcards
What is the therapeutic range for lithium?
0.5-1.2mEq/l
At what level does lithium toxicity occur?
1.5mEq/l or higher
Which medication is the gold standard for treating manic episodes?
lithium
Which mood stabilizer has anti-suicidal effects?
lithium
Which medication is the neuroprotective treatment of choice for bipolar disorder?
lithium
Which baseline labs should be ordered prior to initiating lithium?
TSH, serum creatinine, BUN, and pregnancy test; EKG for patients >50
What are side effects of lithium treatment?
Hypothyroidism, weight gain, fine hand tremors, fatigue, mental cloudiness, headaches, course hand tremors with toxicity, nystagmus, maculopapular rash, pruritis, diarrhea, vomiting, cramps, anorexia, diabetes insipidus (polydipsia, polyuria), edema, microscopic tubular changes, t-wave inversion, dysrhythmias, leukocytosis
What are the signs of lithium toxicity?
Severe nausea, diarrhea, vomiting, confusion, convulsions, drowsiness, blurred vision, slurred speech, muscle weakness, heart palpitations, coarse hand tremors, unsteadiness while walking or standing (ataxia)
Intervention for lithium toxicity?
Discontinue lithium and monitor serum lithium levels
Hypertensive crisis occurs when:
MAOIs are taken in conjunction with food containing tyramine, a dietary precursor to NE
Medications taken in conjunction with MAOIs that can cause hypertensive crisis:
Meperidine, stimulants, and other sympathomimetics; decongestants, TCAs, atypical antipsychotics, St. John’s wort, L-tryptophan, asthma meds
Symptoms of hypertensive crisis include:
Elevated BP; sudden, explosive-like headache, usually in occipital region; facial flushing, palpitations, pupillary dilation, diaphoresis, fever
Treatment of hypertensive crisis:
DC the offending agent, administer phentolamine, stabilize fever
Teratogenic risks of benzos:
floppy baby syndrome, cleft palate
Teratogenic risks of carbamazepine:
neural tube defects
