Mood stabilisers Flashcards
What are mood stabilisers used for?
Treat mania
What are the mood stabilisers?
- Lithium
- Sodium valproate
- Carbamazepine
- Lamotrigine
MoA lithium?
Inhibits adenylate cyclase
AEx lithium?
- Nausea
- Tremor
- Hypothyroidism
- Cardiac dysrhythmias
- Diarrhoea
- Diabetes insipidus (thirst, urination, weight gain, acne)
AEx lithium at toxic levels?
-Significant alterations in consciousness, seizures, coma and death may occur
Ix pre lithium Rx?
-FBE
-UEC (inc specific gravity, BUN and creatinine)
-TFTs
-fasting blood glucose
-bHCG
-ECG
pre treatment and yearly thereafter (6mo for TFTs and UEC)
How frequently should lithium levels be monitored?
At least 3mo once pt stabilised on Rx
Mx lithium associated tremor?
Propranolol
Valproic acid MoA?
Opens chloride channels (largely unknown)
AEx valproic acid?
- Thrombocytopenia
- NEURAL TUBE DEFECTS IN PREGNANCY
- Pancreatitis
- Weight gain
- Hair loss
- GIT upset
- Cognitive dulling
Ix pre valproic acid Rx?
- FBE
- LFTs
- Pancreatic enzyme (lipase)
- bHCG
MoA carbamazepine?
Inhibitis kindling; inhibits repetitive firing of action potentials by inactivating sodium channels
AEx carbamazepine?
- N/V
- Slurred speech
- Dizziness / drowsiness
- Low WBC
- High LFTs
- Cognitive slowing
- Craniofacial defects in newborn
Ix pre and during carbamazepine Rx?
- FBE (agranulocytosis) pretreatment
- FBE (inc. platelet, reticulocyte) + iron studies: fortnightly for 2/12 –> then every 3/12
- LFTs: monthly for 2/12 –> then 3mo
- UEC and ECG (pre and then yearly)
Other effect of carbamazepine?
Potent induce of p450 system
