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Pharm Test 3 > Mood Stabilizers > Flashcards

Mood Stabilizers Flashcards

1
Q

What are the indications for mood stabilizers?

A

bipolar, cyclothymia, schizoaffective, impulse control, intermittent explosive disorders

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2
Q

What are the three classes of mood stabilizers?

A

lithium
anticonvulsants
antipsychotics

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3
Q

What is the only mood stabilizing medication proved to reduce suicide rates?

A

lithium

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4
Q

What are three factors that predict good response to lithium?

A

prior success/family history
classic pure mania
mania followed by depression

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5
Q

What are three tests to attain prior to starting lithium?

A

baseline creatinine
TSH
CBC

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6
Q

During the first trimester, lithium is associated with increased risk of ____________ in pregnancy

A

ebstein’s anomaly

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7
Q

This drug may cause polyuria or polydypsia secondary to ADH antagonisms

A

lithium

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8
Q

What are the AE seen with mild lithium toxicity?

A 
vomiting
diarrhea
ataxia
dizziness
slurred speech
nystagmus
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9
Q

What are the AE seen with moderate lithium toxicity?

A

n/v anorexia
blurred vision, clonic limb movements
convulsions, delirium, syncope

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10
Q

What are the AE seen with severe lithium toxicity?

A

generalized convulsions

oliguria and renal failure

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11
Q

What three drugs have FDA approval for adjunct therapy not mono therapy?

A

quetiapine (and XR)

ziprasidone

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12
Q

What drug would be a good choice for a pt who is a rapid cycler w/a h/o ETOH abuse?

A

depakote

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13
Q

When is it time to decreased a dose d/t increases in LFTs

A

When they triple thier baseline

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14
Q

What is the MOA of typical antipsychotics?

A

D2 dopamine receptor antagonists

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15
Q

Low potency typical antipsychotics interact with ______________ receptors

A

nondopaminergic

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16
Q

Low potency typical antipsychotics have more ___________ and ___________ adverse effects

A

cardiotoxic

anticholinergic

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17
Q

What kind of drug are chlorpromazine and thioridazine?

A

low potency typicals

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18
Q

What kind of drug is fluphenazine?

A

typical antipsychotic

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19
Q

What kind of drug is haloperidol?

A

typical antipsychotic

20
Q

What kind of drug is pimozide?

A

typical antipsychotic

21
Q

MOA of atypical antipsychotics

A

serotonin-dopamine 2 antagonists (SDAs)

22
Q

What makes the atypical antipsychotics, atypical?

A

they affect dopamine and serotonin neurotransmission in the four key dopamine pathways in the brain

23
Q

At doses greater than 6 mg, risperidone acts as a ___________ antipsychotic

A

typical

24
Q

What is the drug most likely to cause hyperprolactinemia?

A

risperidone

25
Q

With what drug may you see weight gains up to 30-50 lbs?

A

olanzapine

26
Q

What is the drug most likely to cause orthostatic hypotension?

A

quetiapine

27
Q

What drug causes significant QT prolongation in susceptible patients?

A

ziprasidone

28
Q

Ziprasidone _______________ cause weight gain

A

does not

29
Q

Absorption of ziprasidone is ________ with food

A

increased

30
Q

What is the unique MOA of aripiprazole?

A

D2 partial agonist

31
Q

What drug can cause potential intolerability d/t akathisia/activation

A

aripiprazole

32
Q

This drug is reserved for patients refractory to other treatments d/t its side effects

A

clozapine

33
Q

This drug is associated with agranulocytosis and therefore requires regular blood draws

A

clozapine

34
Q

What drug is associated with the most sedation, weight gain and transaminitis?

A

clozapine

35
Q

What drug REQUIRES bid dosing

A

iloperidone

asenapine

36
Q

This drug must be titrated over 4 days to 12 mg in order to minimize the risk of orthostatic hypotension

A

iloperidone

37
Q

_________ are inhibitors of 3A4 (ketoconazole) or 2D6 (fluoxetine, paroxetine)

A

iloperidone

38
Q

This drug is given sublingually

A

asenapine

39
Q

Asenapine is a ___________ inhibitor

A

CYP1A2

40
Q

What drugs can you use to prevent extrapyramidal side effects of antipsychotics?

A

anticholinergics
bentropine
trihexyphenidyl
diphenhydramine

41
Q

What two drugs would in contraindicated in a patient with elevated total cholesterol and low HDL?

A

olanzapine

quetiapine

42
Q

in anxiety disorders, you often use ___________ with SSRIs or SNRIs

A

anxiolytics

43
Q

MOA of buspirone

A

5HT1A agonists

44
Q

This drug will not reduce anxiety in patients that are use to taking BZDs because there is no sedation effect

A

buspirone

45
Q

This type of drug is often used for CNS deperssant w/d protocols and ETOH w/d

A

benzodiazapines

46
Q

Which benzo has the shortest half life?

A

triazolam (2-3 hours)

47
Q

Which benzo has the longest half life?

A

flurazepam (40-100 hours)

Pharm Test 3 (5 decks)

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