Other meds Flashcards
What is lithium used as?
Mood stabiliser
in bipolar affective disorder
what type of drug is it?
does it have a wide or narrow therapeutic index?
what is the index?
CAMP-i (cyclic AMP inhibitor)
Narrow (0.4-1.0 mmol/L)
what 3 drugs does lithium interact with and to cause what?
NSAIDS (to cause AKI)
Diuretics (to increase dehydration)
ACE - i
What does lithium con stand for?
Leukocytes
Insipidus (diabetes)
Tremor (fine = normal, coarse = toxicity)
Hydration low and HypOthyroid
Increased thirst
Urine output high
Mums beware (teratogenic)
CV issues eg, Ebstein and arrhythmias)
Oedema
Nephrotoxic (stop lithium)
what level of lithium classes as lithium toxicity and what is the acronym to remember symptoms?
1.5+ mmol/L
LITHIUM CON
When and what to measure when prescribing lithium?
Serum Li 12 hr post dose, Weekly till stable then 3 monthly
what is ebstein anomaly?
heart defect in baby
don’t give lithium to pregnancy women
what tests do we do (general)? for Li
FBC, U+E, TFT, eGFR, BMI, ECG
What can happen months after stopping Li?
what is the acronym?
Neurological Sx
SILENT
What does SILENT stand for?
what Sx?
Syndrome of Irreversible Lithium Effectuated Neurotoxicity
Cerebellar Sx
EPSE
Dementia
What are some other mood stabilisers?
Carbamazepine
Sodium valproate
(also work as anti epileptics)
Benzodiazepines
what type of medications are they?
used in?
GABA agonists
sedating Px
alcohol withdrawal
status epilepticus
examples of benzos?
Chlordiazepoxide (medium)
Diazepam (short)
Lorazepam (long)
SE of benzos?
overdose Tx?
Resp depression
sedation
amnesia
IV Flumenazil
Anxiolytic (hypnotic)
eg?
type of drug?
helps with?
Zopiclone
GABA agonist
helps insomnia
what does ECT stand for?
electrocompulsive therapy
what is ECT?
used in which patient?
Electrode guided current to brain parenchyma in High suicidality, refractory depression, severe mania, catatonic schizophrenia
Complication and CI of ECT?
amnesia
Confusion
Child <12y, htn, MI <3months ago
what are 4 types of talking therapy?
CBT
DBT
IPT
Couple therapy
what does CBT stand for?
what is it used for?
how is it used?
cognitive behavioural therapy
change NEGATIVE thoughts
breaks problems into STEAP (situation, thoughts, emotions, actions, physical feelings)
what does DBT stand for?
what is it used for?
Dialectical behaviour therapy
chnaged negative thoughts like CBT and promotes ACCEPTANCE
what does IPT stand for?
what is it used for?
interpersonal therapy
resolving relationship problems
what is couples therapy used to do?
promote communication and strength
Reduce emotional avoidance
Modify dysfunctional behaviour
