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psychiatry > pharma: lithium and anticonvulsants > Flashcards

pharma: lithium and anticonvulsants Flashcards

1
Q

mood stabilisers

A

lithium
anticonvulsants
antipsychotics

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2
Q

lithium indications

A

long term prophylaxis mania + depression

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3
Q

lithium factors predicting positive response

A

personal/family history
pure classic mania
mania followed by depression

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4
Q

lithium: before starting

A

pregnancy test
TSH
U&Es

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5
Q

lithium: monitoring

A

steady state - levels
3mo - levels
6mo - creatinine and TSH

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6
Q

lithium: goal

A

0.6-1.2

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7
Q

lithium side effects

A 
dry mouth
polyuria
fine tremor
tired
weight gain 
N&V, diarrhoe
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8
Q

lithium toxicity levels

A

mild - 1.5-2
mod 2-2.5
sev 2.5+

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9
Q

lithium toxicity signs

A 
blurred vision 
slurred speech
clonic limb movements
convulsions
oliguria, renal failure
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10
Q

lithium: if have cardiac disease

A

ECG

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11
Q

valproic acid

A

mania prophylaxis

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12
Q

valproic acid factors predicting positive response

A

rapid cyclers
mixed pts
co-morbid subtance issues
co-morbid anxiety disorders

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13
Q

valproic acid: before start

A

pregnancy test
LFTs
FBC

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14
Q

valproic acid: monitoring

A

steady state: level, LFTs, FBC

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15
Q

valproic acid: goal

A

50-125

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16
Q

valproic acid: side effects

A 
nausea, vomiting
weight gain 
tremor
sedation 
hair loss
17
Q

carbamazepine

A

mania and mania prophylaxis

rapid cyclers and mixed pts

18
Q

carbamazepine: before starting

A

LFTs, FBC, ECG

19
Q

carbamazepine monitoring

A

steady state - level, FBC, LFT

20
Q

carbamazepine goal

A

4-12mcg

21
Q

carbamazepine side effects

A 
rash
nausea, diarrhoea
sedation 
AV conduction delay 
water retention
22
Q

lamotrigine before start

A

LFTs

23
Q

lamotrigine starting it

A

titrate - 25 - 50 - 100

24
Q

lamotrigine side effects

A

N&V
sedation, ataxia
toxic epidermal necrolysis
Stevens Johnson’s syndrome

25
Q

lithium effect fetus

A

ebstein’s anomoly of heart

26
Q

valproic acid effect fetus

A

neural tube defect

psychiatry (20 decks)

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