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PHRM 845 > L70- Ott bipolar > Flashcards

L70- Ott bipolar Flashcards

1
Q

3 common comorbidities with bipolar

A

alcoholism and substance use (50-60%)
+ anxiety

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2
Q

manic episodes in bipolar I typically last how long?

A

at least 1 week

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3
Q

hypomanic episodes in bipolar II generally last how long

A

4 or more days

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4
Q

what types of drugs are the foundation of acute and maintenance treatment for bipolar disorders

A

mood stabilizers

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5
Q

1st line for bipolar

A

lithium or valproic acid

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6
Q

what can also be used as 1st line that isnt lithium or valproic acid?

A

atypicals as monotherapy or adjunct

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7
Q

T or F: Lithium is associated with a decrease in suicidality

A

true

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8
Q

what is the conversion ratio for liquid vs tab/cap forms of lithium?

A

1:1**

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9
Q

IR lithium is associated with what

A

N/V

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10
Q

CR lithium is associated with whta

A

diarrhea

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11
Q

T or F: Lithium has a very wide therapeutic index

A

false, narrow af boi

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12
Q

what serum level of lithium is considered to be approaching toxicity?

A

> 1.2-1.5 mEq/L

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13
Q

Toxicities to monitor w/ lithium: (8 of them)(1 main one)

A

GI
ataxia
hypothyroidism *
polyuria
polydipsia
acne
dry mouth
weight gain
ecg changes

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14
Q

considerations for lithium in pregnancy

A

avoid in 1st trimester bc of cardiac structural abnormality

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15
Q

when to really consider ECG monitoring in lithiu

A

patient above 40

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16
Q

how soon should a lithium level be collected after starting

A

72 hours

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17
Q

what effect do aces/arbs/thiazides/NSAIDs have on lithium

A

decreased renal clearance (rise in Li levels)

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18
Q

what effect do caffine/osmotic diuretics/loops have on lithium

A

increased renal clearance (decreased lithium levels)

19
Q

what effect does sodium bicarbonate have on lithium

A

increased lithium excretion (lower Li levels)

20
Q

which dosage form of valproic acid (valproate) do you see most often?

A

ER

21
Q

conversion for dosage forms of valproate

A

1:1

22
Q

T or F: ER form is 10-15% less bioavailable than DR form in valproate

A

true

23
Q

what dosage forms of valproic acid have a higher risk for GI ulcerations

A

syrup and capsule sprinkle form

24
Q

T or F: Use Valproate in caution in 2nd and 3rd trimester

A

false, dont use at all

25
Q

What bipolar drug causes PCOS in up to 50% of women?

A

valproic acid

26
Q

how might you treat PCOS due to valproic acid

A

metformin

27
Q

T or F: valproic acid is associated with weight gain

A

true

28
Q

drug that has adverse effect for hyperammonemia

A

valproic acid

29
Q

baseline monitoring for valproate (3)

A

pregnancy test, LFTs, CBC w/differential

30
Q

valproate has a sig concern with combo use of what other drug and for what reason

A

lamictal, SJS

31
Q

what are four other mood stabilizers that can be considered that arent the big ones

A

carbamazepine, oxcarbazepine, lamotrigine, topiramate

32
Q

associated w/ thrombocytopenia/
hematologic effects
A. carbamazepine
B. oxcarbazepine
C. Lamotrigine
D. topiramate

A

A

33
Q

associated with hyponatremia
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

b

34
Q

1st line for depressive sxs in bipolar
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

C

35
Q

NOT useful for acute tx or for manic episodes
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

C

36
Q

may cause weight loss
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

D

37
Q

heat intolerance/hypohidrosis
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

D

38
Q

metabolic acidosis and kidney stones
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

D

39
Q

possible teratogen - cardiac structural defects
A. carbamazepine
B. oxcarbazepine
C. lamotrigine
D. topiramate

A

D

40
Q

FDA-approved for bipolar depression – dose at least 300mg/day
A. seroquel
B. abilify
C. Sybax (olanz/fluox)
D. Lurasidone

A

A

41
Q

FDA-approved for adjunctive treatment in depression in combination with antidepressant treatment, may see increased use for bipolar depression
A. seroquel
B. abilify
C. Sybax (olanz/fluox)
D. Lurasidone

A

b

42
Q

FDA-approved for bipolar depression (just this)
A. seroquel
B. abilify
C. Sybax (olanz/fluox)
D. Lurasidone

A

D

43
Q

FDA-approved for bipolar depression and treatment-resistant depression
A. seroquel
B. abilify
C. Sybax (olanz/fluox)
D. Lurasidone

A

c

44
Q

what drug class is often used in pregnancy for bipolar?

A

atypicals, except olanzapine and clozapine

PHRM 845 (34 decks)

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