Module 4 - part 3

Question 1

Half life of lamictal (lamotrigine)

Answer 1

25 hours

Question 2

Adverse effects of lamotrigine

Answer 2

Dizziness
ataxia
headaches
somnolence
blurred vision
nausea
Rash can develop into SJS

Question 3

voltage-gated sodium channel blocker
blocks glutamate
anticonvulsant/mood stabilizer

Answer 3

Lamotrigine

Question 4

consideration of dosing when combining lamotrigine and depakote

Answer 4

Half the dose of lamotrigine in the presence of depakote

Question 5

dosing for lamotrigine (Lamictal)

Answer 5

start 25 mg/day the firs 2 weeks.

Double dose weekly after that up to 200 mg/day

Question 6

drugs that induce metabolism of Lamictal

Answer 6

carbamazepine, phenobarbital, phenytoin

lamictal can be given up to 400 mg/day with these

Question 7

May be more effective in treating depressive episodes than manic episodes

Answer 7

lamictal

Question 8

Used off label for bipolar depression, bipolar maintenance

Answer 8

carbamazepine (Tegretol)

Question 9

Therapeutic level for carbamazepine

Answer 9

4-12 mmol/L

Question 10

take with food (ehances absorption)

Answer 10

Tegretol

Question 11

half life of Tegretol

Answer 11

18-54 hours

Question 12

considerations for Carbamazepine (Tegretol)

Answer 12

metabolized by liver
reaches steady state in 2-4 days
Lots of drug to drug interactions
Use with Depakote requires higher doses

Question 13

Decreases blood concentrations of oral contraceptives

Answer 13

lamotrigine (Lamictal)

carbamazepine (Tegretol)

Question 14

Adverse effects of carbamazepine

Answer 14

pancreatitis
blurred vision
dizziness
GI disturbances
agranulocytosis
SJS

Question 15

Target dose of carbamazepine for bipolar disorder

Answer 15

1200 mg/day (ages 13 and older)

start at 200 mg twice daily, then increase each week up to 1200 mg/day

Question 16

Poor mood stabilizer but used for aggression and impulsivity like in ADHD

Answer 16

Oxcarbazepine (Trileptal)

Question 17

schedule IV drug for off-label anxiolytic, panic disorder

Answer 17

Gabapentin (neurontin)

Question 18

Helpful for alcohol cravings

Answer 18

Gabapentin

Question 19

little mood stabilizing effects but indicated for epilepsy, migraine prevention, binge eating, bulimia

Answer 19

Topiramate (Topamax)

Question 20

Side effects of Topamax

Answer 20

Weight loss, cardiac arrhythmias

somnolence, dizziness, anorexia, memory problems, SI