Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phar 507 > Therapeutics of Mood Stabilizers > Flashcards

Therapeutics of Mood Stabilizers Flashcards

1
Q

What is mania, hypomania

A

Mania is an abnormal and persistent elevated mood lasting for AT LEAST ONE WEEK while hyomania is less severe and only lasting at least FOUR DAYS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is rapid cycling

A

GREATER THAN 4 mood epsisodes in 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are characteristics of Bipolar Disorder 1

A

BD1 involves episodes of mania, major depression, and mixed features (best characterized by mania)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are characteristics of Bipolar Disorder 2

A

BD2 involves hypomania, major depression and mixed features (best characterized by its depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F: Bipolar disorder can be diagnosed following a sing visit

A

False: Bipolar disorder should never be diagnosed following a single visit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mean age of onset of BD1,BD2

A

18 years, mid-20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What medications are potential causes of mania

A

Antidepressants (SSRI, MAOI, TCA), steroids, amphetamines, Bronchodilators (ephedrine, albuterol, theophylline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the first line for a MANIC EPISODE

A

Lithium, valproate, or SGA (quetiapine, asenapine, aripiprazole, paliperidone, risperidone, cariprazine, Or a combination SGA AND lithium or valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In Bipolar 1 depression what drugs should be used with caution

A

Antidressants (SSRIs and SNRIs), associate with manic switch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the first line treatment for Bipolar 1 depression

A

Quetiapine, lithium, lamotrigine, lurasidone/ Lurasiodne PLUS lamotriginem, Quetiapine PLUS lithium, can add on valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the kinetics of lithium, how is it metabolized

A

1st order kinetics (double the dose double the concentration), excreted by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T/F: EVeryone exretes lithium the same

A

False: Manic patients exretes lithium faster than normal patients, so as patients get better the drug is not excreted as quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the normal dose of lithium, what is the blood level desired for acute mania, maintenance

A

1500-2000 mg/day, 0.8-1.2, 0.6-0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long should it take for lithium be therapeutic when first started, when changing the dose

A

21 days, 4-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common side effect of lithium, how is it managed

A

Nausea/vomiting/GI pain (33%), usually transient but can also take with food in divided doses OR switch to sustain release preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the side effect of lithium that effects 6-20% of patients, treatment

A

Diarrhea, immediate release preparation or liquid form

17
Q

What are the more severe side effects of lithium

A

Leukocytosis (increase WBCs by 30-40%), thrombocytosis (increased platelets), tremor, polydipsia/poluria, weight gain

18
Q

How is tremor treated do to lithium

A

Decrease dose or low dose beta-blocker (propanolol)

19
Q

What are drug interatctions of lithium causing what

A

Diuretics, ACEI, and NSAIDS, increase lithium level

20
Q

What lithium level is known as mild, moderate, and severe

A

1.2 - 2.5 mEq/L, 2.0-3.0 mEq/L, greater than 3.0 mEq/L

21
Q

What factors that will reduce lithium clearance

A

Low sodium intake, extra sodium loss, renal impairment, being old

22
Q

T/F: Lithium is not recommended in pregnant patients

A

True

23
Q

What drugs increase lithium clearance

A

Caffeine and theophylie

24
Q

What drug drug interactions cause nephrotoxicity when used with lithium

A

Carbamazepine and Antipsychotics (mostly FGAs)

25
Q

What is the only test that do not be made when a person is started on lithium

A

Liver tests

26
Q

How is valporic acid metabolized

A

Glucorondidation through the liver

27
Q

What is the therapeutic trial for using valproic acid to treat mania

A

21 days

28
Q

What is the BBW of valproic acid

A

Heptaotxicity, Teratogenicity, Pancreatitis

29
Q

What are the adverse effects of valrpoic acid

A

Headaches, dizzines, N/V, weight gain , alopeciathrombocytopenia and neutropenia

30
Q

How should the dose of VPA change if switching from IR to ER

A

The dose will need to increase by 8-20%

31
Q

What enzyme does VPA inhibit

A

Phenytoin

32
Q

What is the target dose for lamotrigine, what is it used for

A

200 mg/day, maintenance for manic or depressed mood episodes

33
Q

What is the BBW for lamotrigine

A

Rash (SSJ)

34
Q

What are the common ADRs at high doses

A

Diplopia (double vision) and dizziness

35
Q

What are the lamotrigine drug interactions and what happens

A

Valproic acid: decrase clearance due to competition for hepatic metabolism, estrogen: increase clearance of lamotrigine

36
Q

What is the starting dose for carbamezapine being used to treat mania, maintenance range, therapeutic trial

A

200 mg BID, 400-1200 mg/day, 21 days

37
Q

T/F: Lamotrogine can be used in manic episodes

A

False: Lamotrigine needs to be titrated to the target dose so it will never be used to treat acute episodes

38
Q

What is the BBW of carbamazepine

A

Aplastic anemia, agranuloocytosis risk, skin rash in patients with HLA-B 1502 allele (Asians)

Phar 507 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions