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MH701 Psychopharmacology > Module 4 - Mood Disorders > Flashcards

Module 4 - Mood Disorders Flashcards

1
Q

Time it takes for lithium to reach peak levels

A

1-1.5 hours

4-5 hours with controlled release

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2
Q

Time it takes for lithium to reach equilibrium

A

5-7 days

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3
Q

half life of lithium

A

18-24 hours

shorter in children, longer in older adults

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4
Q

Controls acute manic episodes

takes 1-3 weeks for full effects of antimania

A

Lithium

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5
Q

Best course when depression occurs while patient is on maintenance lithium

A 
Increase concentration to 1-1.2 mEq. OR
Add Cytomel (thyroid hormone)
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6
Q

Drugs that increase concentrations of lithium

A

NSAIDs
Thiazide diuretics
ACE Inhibitors
Metronidazole

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7
Q

mild to moderate signs of lithium toxicity

1.5-2.0 mEq/L

A

vomiting
abdominal pain
ataxia, dizziness, slurred speech, nystagmus, muscle weakness

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8
Q

Moderate to severe signs of lithium toxicity

2.0-2.5 mEq/L

A

Anorexia, persistent N/V

Blurred vision, clonic limb movements, hyperactive deep tendon reflexes, convulsions, delirium coma, stupor

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9
Q

Severe signs of lithium toxicity

>2.5 mEq/L

A

convulsions, oliguria, renal failure, death

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10
Q

When to take lithium levels

A

12 hours after last dose

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11
Q

Therapeutic level of Depakote

A

50-100 mmol/L

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12
Q

Half life of Depakote

A

10-16 hours

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13
Q

Average length of response to Depakote for acute mania

A

5 days

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14
Q

Useful to decrease agitation and impulsivity

A

Depakote

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15
Q

Side effects of. Depakote

A

GI irritation, nausea, sedation, tremor, weight gain, hair loss, can decrease Ca+ and VD

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16
Q

rare but serious side effect of Depakote

A

Platelet dysfunction, agranulocytosis

check CBC

17
Q

Usual dose range of Depakote for acute mania

A

1200-1500 mg/day

18
Q

Labs to check before starting Depakote

A

hepatic panel, CBC with platelet counts, pregnancy test,

19
Q

Labs to monitor every 6 months or so while on Depakote

A

LFTs, VPA level, platelets

Monitor for metabolic syndrome

20
Q

FDA approved for maintenance of bipolar-1

A

Lamotrigine (Lamictal)

Lithium

21
Q

half life of lamictal

A

25 hours

22
Q

severe effect of Lamictal

A

Steven Johonson syndrome

23
Q

Lamictal and Depakote together

A

Depakote doubles Lamictal serum concentrations

24
Q

normal dosing of lamictal

A

25 mg QD for 2 weeks
50 mg QD for 2 weeks……
Up to 200 mg/day

25
Q

dosing of lamictal with depakote

A

25 mg every other day for two weeks

up to 100 mg/day

26
Q

dosing of lamictal with carbamazepine, phenobarbital, and phenytoin

A

start higher at 50 mg/day for two weeks up to 400 mg/day. Split dose to BID when you get to 100 mg

27
Q

Can cause weight gain

A

Depakote

Monitor weight and BMI

28
Q

Common side effects of Depakote

A 
GI Irritation
Nausea
Sedation
Tremor
Weight Gain
Hair loss (take zinc)
Decreased Calcium and VD

MH701 Psychopharmacology (19 decks)

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