Bipolar Flashcards
(22 cards)
Affects synthesis, storage, release, reuptake of NE, serotonin, dopa, ach, gaba
Lithium
Competes w Ca, Mg, K, Na, in body tissue and sites
Lithium
Not metabolized, it’s renally excreted (renal dysfunction can double half life)
Lithium
Treats mania and depression
Decrease # of acute manic episodes
Lithium
Use for - schizophrenia, migraine, impulse control, aggression
Lithium
AD- GI problems, nausea, polydipsia, polyuria, nocturia, dry mouth, hand tremor, leukocytosis, m weakness, difficulty concentrating, impaired memory
Lithium
Long term effect of lithium
Weight gain, rash n acne, hypothyroidism, psorias, alopecia, T wave changes, nephrotoxicity, diabetes insipidus, hand tremor
Overdose- >1.5 mEg/L
Agitation, confusion, headache, nystagmus, tremors
OD: >3
Need for dialysis
Twitching, seizure, irreversible brain damages, respiratory complications, coma, death
70-80% efficacy
Better long term treatment than other drugs (better absorbed)
Not affected by food
Lithium
Cons
Onset is 5-7d (antimanic in 10-21 d, antidepressant in 28 d)
Lithium
Decrease the dose in elderly Pts on diuretics, Pt w renal ds, Dehydrated pt, Pt w poor CO
Lithium monitoring
Lithium monitoring
Decrease the dose in elderly Pts on diuretics, Pt w renal ds, Dehydrated pt, Pt w poor CO
ECG - every 6-12 m (pt>50 yrs)
Lithium monitoring
Lithium monitoring
Get vitals, CBC, weight, thyroid functions, renal functions, urinalysis
Has narrow therapeutic index = o.6-1.2
Lithium monitoring
Lithium therapeutic index
In actively manic pts- levels should be
0.8-1.5
Uses- maintenance of bipolar disorders
Lamotrigine
AD
Liver toxicity, pancreatic toxicity, sedation, weight gain
Valproate
Uses
Treat acute mania
CBZ
AD
Sedation, heme effects
CBZ
1st truly anti manic drug for bipolar depression
Lithium
