Pharm-Bipolar Flashcards
What is the first line agent for acute mania, acute bipolar depression, and continuation treatment of bipolar I and II disorders?
Lithium
What can happen if a person who is bipolar d/c taking lithium suddenly or is noncompliant?
It can increase chance of relapse
It is not recommended to combine lithium with ?
CCBs d/t reports of neurotoxicity and severe bradycardia
How can diarrhea as a side effect of lithium be treated?
You can try switching from tablet to liquid form
What side effects occur in 70% of pts on LIthium? How can this be helped?
Polydipsia with polyuria and nocturia, can help this by switching to once-daily bedtime dosing
When a pt is on Lithium and ______ meds, you have to monitor closely for SE and give??
Blood pressure meds and give K+ supplementation
How does lithium affect the kidneys?
reduces the kidney’s ability to concentrate urine and can cause a nephrogenic diabetes insipidus ( low urine specific gravity and a low osmolality polyuria
LIthium is concentrated where?
In the thyroid gland
How does lithium affect the thyroid?
it interferes with thyroid hormone synthesis and can induce the formation of thyroid antibodies
Is lithium-induced hypothyroidism dose-related? Who does it affect the most?
NO, affects women 10x more frequently, especially rapid cyclers
Does hypothyroidism require you to d/c lithium?
No, you can add a synthroid (levothyroxine)
What can elevate lithium levels?
Thiazide diuretics, NSAIDS, COX-2-Is, ACE-Is, and salt restricted diets
Other therapies for Bipolar besides lithium?
Antipsychotics, antidepressants
Example of a long-acting benzodiazepine?
Valium
Example of a intermediate-acting benzo?
Xanex
