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Pharm 845 Exam #3 > Pharmacotherapy of Bipolar Disorders- Dr. Hager > Flashcards

Pharmacotherapy of Bipolar Disorders- Dr. Hager Flashcards

1
Q

Given treatment resistance and intolerance to SSRI and SNRI medications with a concern for obesity, which medication is the best next step for this patient

A
  • Bupropion

- Can actually cause weight loss

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2
Q

Bipolar I

A
  • Mania
  • Major depression
  • Requires hospitalization
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3
Q

Bipolar II

A
  • Hypomania

- Major depression

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4
Q

Cyclothymic disorder

A

Sub threshold

  • Hypomania
  • Depression
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5
Q

Mania definition

A
  • Distinct period
  • Abnormal
  • Persistent
  • Irritable mood
  • Increased activity/energy
  • Greater than 1 week
  • Usually requires hospitalization
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6
Q

Hypomania

A
  • 4 to 6 days
  • Not severe enough to cause impairment or hospitalization
  • No psychosis
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7
Q

Screening for bipolar disorder

A
  • MDQ > 7

- Self reported scale

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8
Q

Non-Response

A

-Less than 25% reduction

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9
Q

Partial respones

A

-Between 25 and 50% response

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10
Q

Response

A

-Greater than 50% reduction in symptoms

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11
Q

Remission

A

-Absence of mood symptoms for greater than 2 months

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12
Q

Maintenance phase

A

-Prevent relapse to any mood episode

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13
Q

Standardized mean difference (SMD) equation

A

(Treatment effect - Placebo effect)/ Std Dev

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14
Q

Number needed to treat (NNT) equation

A

1/ARR

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15
Q

Name a drug that is NOT efficacious for acute mania

A

-Lamotrigine

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16
Q

First generation antipsychotics (FGA) mechanism of action

A

-D2 antagonist

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17
Q

List FGAs

A
  • Haloperidol & Fluphenazine
  • Perphenazine
  • Chlorpromazine & Thioridazine
18
Q

Second generation antipsychotic (SGA) TWO mechanisms of action

A

1) D2 antagonist and 5HT2 antagonist

2) D2 partial agonist and 5HT2 antagonist

19
Q

List D2/5HT2 antagonist (SGAs)

A
  • Risperidone, Olanzapine
  • Ziprasidone, Lurasidone
  • Quetiapine, Clozapine
20
Q

List D2 partial agonist and 5HT2 antagonist

A
  • Aripiprazole
  • Brexpiprazole
  • Cariprazine
21
Q

Which antipsychotics have minimal neuroleptic potential

A
  • Clozapine

- Quetiapine

22
Q

Which antipsychotics have a fast off (kiss-and-go) effect

A
  • Clozapine
  • Quetiapine
  • Olanzapine
23
Q

Is lamotrigine an ideal mood stabilizer?

A

-NOOOO

24
Q

Name some drugs with NO mood stabilizing effects

A
  • Phenytoin
  • Gabapentin
  • Topiramate
  • Benzodiazepines
25
Q

What phases of bipolar disorder are treated by Ideal mood stabilizers

A

ALL phases:

  • Acute Mania
  • Acute Depression
  • Maintenance
26
Q

List the Ideal mood stabilizers that we learned about in class

A
  • Olanzapine/Fluoxetine
  • Olanzapine
  • Quetiapine
  • Valproate
  • Lithium + Valproate
  • ECT
27
Q

List the side effects associated with lithium

A
  • Polyuria, diabetes insipidus
  • Cognitive slowing, tremor, sedation
  • Weight gain, hypothyroidism
  • Nausea, diarrhea
28
Q

Lithium can be used to treat what?

A
  • Acute mania
  • Acute bipolar depression
  • Prevention of bipolar disorder relapse
  • Augmentation for acute unipolar depression
29
Q

Can quetiapine be used for acute bipolar depression?

A

-Yes ma’am

30
Q

What are possible side effects of SGAs

A
  • Orthostatic hypotension
  • QT prolongation
  • Psuedoparkinsonism
  • Weight gain
  • Dyslipidemia
  • Neutropenia
31
Q

Which antipsychotic is least likely to cause QT prolongation

A

-Aripiprazole

32
Q

Agents that can cause weight gain

A
  • Olanzapine
  • Gabapentin
  • Amitriptyline
  • MIrtazapine
  • Quetiapine
  • Risperidone
33
Q

Agents that can cause weight loss

A
  • Topiramate
  • Bupropion
  • Fluoxetine
34
Q

Is paroxetine safe in pregnancy?

A

-NOOOOOO

35
Q

Is Olanzapine safe in pregnancy?

A

-Yes ma’am

36
Q

Which agents are pregnancy category “D”

A
  • Lithium
  • Valproate
  • Carbamazepine
37
Q

Which agents are pregnancy category “C”

A
  • Lamotrigine
  • Antipsychotics
  • ETC
38
Q

List some possible side effects of Carbamazepine

A
  • Cytopenia, agranulocytosis
  • Steven johnsons
  • Dizziness/ ataxia
  • Hyponatremia
  • Does NOT cause insomnia
39
Q

What is a common side effect of lamotrigine

A

-Benign drug rash

40
Q

What is more common: bipolar disorder or anxiety/depressive disorder

A

-Depressive/ anxiety disorders

Pharm 845 Exam #3 (7 decks)

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