pharmacology 4

Question 1

Bipolar disorder is characterised

Answer 1

by changes of mood and affect from very
low (depressed state) to very high (manic state), with not every person
experiencing both extremes

Question 2

Depression phase is frequently more difficult to treat

Answer 2

than mania

Question 3

The depressed state will usually be treated

Answer 3

with antidepressants,

Question 4

manic states

Answer 4

with a mixture of ‘mood stabilising’ medications and

antipsychotics

Question 5

The most common medications for mood stabilisation are:

Answer 5

Lithium carbonate (mania, but routinely used for all types)
• Sodium valproate (mania)
• Carbamazepine (mania)
• Lamotrigine (mania and depression – requires special monitoring)
• Topiramate (ok for depressed phase and for reducing weight)
• Olanzapine (atypical antipsychotic with a benzo-like effect)

Question 6

Lithium carbonate

Answer 6

is a naturally occurring salt. It has been in use
since 1949, and despite more modern medications, remains the
medication of choice for treating bipolar disorder

Question 7

Common adverse reactions lithium

Answer 7

weight gain sedation fine tremor
thirst polyuria
gastrointestinal upset

Question 8

Lithium carbonate treatment requires blood monitoring

Answer 8

• the
  difference between therapeutic levels and toxicity is marginal,
  especially at high doses
  Toxicity leads to nervous system and renal damage
  • Long term use may lead to goiter or a hypothyroid state (40-50% of
  pts) – monitor thyroid function

Question 9

Therapeutic levels for lithium carbonate:

Answer 9

• 0.6 – 1.2 mmol/L for acute mania

* 0.6 – 0.8 mmol/L for maintenance

Question 10

• Toxic

Answer 10

• >2.0 mmol/L
• toxicity may develop at lower levels, particularly in
older clients)

Question 11

• Lithium

• Contraindications

Answer 11

• Cardiac disease
• Renal disease
• Pregnancy & lactation
• Dehydration/sodium depletion
• Brain damage

Question 12

anxiety

disorders

Answer 12

Benzodiazepines (sedative hypnotics) and

antidepressants are both routinely used to treat

Question 13

Common anxiolytic medications include:

Answer 13

alprazolam diazepam

oxazepam

Question 14

Adverse effects include: anxiolytic medications

Answer 14

drowsiness, dizziness, impaired motor coordination
• visual disturbances, agitation
• dependence & decreased effectiveness over time

Question 15

Managing Meds – Nursing Responsibilities

Answer 15

al Medications Depot Medications
Regardless of the type or purpose of medication, nurses who
administer medications have a responsibility to understand the
actions, monitoring, and any potential adverse effects.

Question 16

nurse must have or obtain prior

to asking a patient to ‘comply’ with treatment

Answer 16

Drug interactions, client allergies, monitoring regimes, and
other ethico-legal aspects of medication management are all
examples

Question 17

key factors when aiming for patient

safety and therapeutic outcomes

Answer 17

Assessing for need and efficacy, and documenting and
communicating results, are key factors when aiming for patient
safety and therapeutic outcomes

Question 18

Standard 7: Treatment and support

Answer 18

To meet the needs, goals and
aspirations of people and their families and carers, mental health practitioners
deliver quality, evidence-informed health and social interventions.