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PHRM 845 > Ott Bipolar > Flashcards

Ott Bipolar Flashcards

1
Q

mood pole often experienced in bipolar

A

depression

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2
Q

comorbidities with bipolar

A

alcohol and substance abuse
anxiety disorder

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3
Q

bipolar 1 disorder classification

A

greater than 1 manic episodes

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4
Q

bipolar II disorder classification

A

hypomanic episodes

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5
Q

1st line treatment bipolar

A

lithium or valproic acid

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6
Q

lithium associated with what

A

decrease in suicidality
narrow therapeutic index (could overdose)

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7
Q

dosage forms of lithium ratio

A

1:1

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8
Q

what can happen if a lithium overdose

A

renal function decrease, dialysis

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9
Q

lithium toxicities

A

GI
ataxia
coarse hand tremor
altered mental status
seizure lethargy
confusion
agitation

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10
Q

lithium side effects

A

fine hand tremor
hypothyroidism
polyuria
polydipsia
acne
dry mouth
weight gain
ECG

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11
Q

lithium should be avoided when?

A

1st trimester (teratogenic)
cause cardiac structural abnormality

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12
Q

lithium monitoring

A

everything
renal stuff especially

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13
Q

drug interactions with lithium decreased clearance

A

ACE
ARB
thiazide diuretics
NSAIDS
(increase lithium levels 25%)

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14
Q

drug interactions with lithium increased clearance

A

caffeine
osmotic diuretics
loop diuretics
(decrease lithium levels)

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15
Q

which drug available in multiple dosage forms and risk for med errors

A

valproate

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16
Q

which dosage form less bioavailable than DR

A

ER - 10-15%, lower serum concentrations

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17
Q

which valproate dosage forms higher risk for side effects

A

valproic acid syrup (IR) and capsule sprinkle
higher risk for GI ulcers (esophageal)

18
Q

serum valproic acid range for efficacy with mania and when should we measure

A

80-125 mcg/mL, obtain 4 days after first dose or increase

19
Q

pregnancy with valproic acid

A

unsafe in all trimesters
obtain baseline pregnancy test
neural tube defects (IQ of offspring down)

20
Q

common side effect of valproic acid in women

A

polycystic ovary syndrome

21
Q

PCOS can occur with what drug

A

valproic acid

22
Q

side effects valproic acid

A

anorexia, N/V/D, dyspepsia, ulceration
increased appetite/weight gain
thrombocytopenia, platelet dysfunction
hyperammonemia

23
Q

lab monitoring in valproic acid

A

pregnancy test
LFTs
CBC
serum ammonia (if we suspect hyperammonemia)

24
Q

drug interaction with valproic acid

A

lamotrigine - increased serum conc
risk stevens johnson syndrome

25
Q

which drug associated with thrombocytopenia/hematologic effects

A

carbamazepine

26
Q

oxcarbazepine CYPs

A

3A4 inducer (no autoinduction)

27
Q

which drug associated with hyponatremia

A

oxcarpazepine

28
Q

lamotrigine use in bipolar

A

depressive symptoms
Not useful in manic symptoms or acute treatment

29
Q

topiramate side effects

A

weight loss
heat intolerance
metabolic acidosis
kidney stones

30
Q

topiramate pregnancy

A

possible teratogen
cardiac structural defects

31
Q

atypical antipsychotics are approved for what in bipoilar

A

acute/maintenance treatment with or without psychosis

32
Q

which antipsychotics arent FDA approved for bipolar

A

brexiprazole
clozapine
iloperidone
paliperidone

33
Q

atypical antipsychotics in bipolar therapy

A

monotherapy or in combo with (valproate/lithium)

34
Q

what applies for antipsychotics in bipolar disorder

A

monitoring parameters for metabolic syndrome and movement side effects

35
Q

suicide risk in which pole of bipolar

A

mania and depression (use lithium cautiously)

36
Q

which drugs are teratogens

A

lithium
valproic acid
topiramate
carbemazepine

37
Q

which drugs better option in pregnancy

A

antipsychotics

38
Q

what do we need in combo with antidepressants in bipolar?

A

mood stabilizer

39
Q

what do we treat anxiety with in bipolar

A

serotenergic antidepressants

40
Q

preferred mood stabilizers in depression

A

lamotrigine, lithium, lurasidone, quetiapine

PHRM 845 (38 decks)

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