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Flashcards in Antidepressants II Deck (13):
1

patients who present with depressive symptoms should be screened for what and why?

screened for bipolar disorder because given antidepressants to those with bipolar can precipitate mania

2

standard treatment for bipolar disorder

Lithium

3

other treatment for bipolar disorder

CRAVZ LOQ

Carbamazepine
Risperidone
Aripiprazole
Valproate
Zisprasidone

Lamotrigine (antiepileptic)
Olanzapine
Quetiapine

all atypical antipsychotics with exception of carbamazepine and valproate

4

what drugs are usually used as alternatives to lithium

Carbamazepine and Valproate

5

mechanism of lithium

inhibits inositol polyphosphatase and inositol monophosphatase --> inhibits synthesis of inositol --> needed for synthesis of PIP2 -->low PIP2 inhibits central adrenergic, muscaranic, and serotonergic neurotransmission

6

since lithium in uncompetitive how does it exert its action

it only affects neurons with active receptors

7

AE of lithium

LMNOP

Lithium side effects
Movement (tremor)
Nephrogenic Diabetes Insipidus
hypOthyroidism
Pregnancy problems

8

used for treatment of lithium induced tremors

beta blockers propanolol and atenolol

9

if lithium cannot be discontinued, what is used to treat nephrogenic diabetes

Amiloride --> inhibits ENAC in collecting tubules --> minimized accumulation of lithium

Thiazides and NSAIDs

10

contraindications of lithium

pregnancy (congenital cardiac defects)
nursing mothers

11

other bipolar medication that should be avoided during pregnancy

Valproate and Carbamazepine

12

effects of using thiazides and NSAIDs to treat nephrogenic diabetes induced by lithium

they treat polyuria but both increase lithium serum concentration

13

other drugs that can cause lithium retention

ACEIs and ARBs

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