bipolar disorder Flashcards
(41 cards)
What is bipolar disorder?
A condition with cycles of recurrent mood fluctuations between mania and depression.
What are the mood episodes in bipolar disorder?
Euphoric mania, hypomania, depression, mixed episode.
Why do many patients stop taking their medication?
They enjoy the euphoric manic phase but then crash into a depressive episode.
How is bipolar disorder treated?
A combination of two or three medications: Mood stabilizers, antiepileptics, antipsychotics, antidepressants, anxiolytics.
Why does lithium require monitoring?
It has a low therapeutic index.
When should lithium levels be checked?
In the morning, right before the next dose.
What is the therapeutic range for lithium?
0.6 – 1.2 mEq/L.
What are common side effects of lithium?
GI distress (N/V/D, abdominal pain), fine hand tremors, polyuria, mild thirst, weight gain, renal toxicity, hypothyroidism, bradydysrhythmias, hypotension, electrolyte imbalances.
What is used to manage lithium-induced hand tremors?
Propranolol.
How can polyuria be managed in lithium therapy?
Drink fluids and possibly use a potassium-sparing diuretic.
What lab values should be monitored for lithium patients?
GFR, creatinine, creatinine clearance, I&O (renal function).
What medication might be needed for lithium-induced hypothyroidism?
Levothyroxine.
< 1.5 mEq/L (Common Toxicity)
N/V/D, thirst, polyuria, muscle weakness, fine hand tremor, slurred speech, lethargy.
1.5 – 2.0 mEq/L (Early Toxicity)
GI distress, mental confusion, poor coordination, coarse tremors, sedation.
2.0 – 2.5 mEq/L (Advanced Toxicity)
Extreme polyuria (dilute urine), tinnitus, involuntary extremity movements, blurred vision, ataxia, seizures, severe hypotension → coma → respiratory complications & death.
> 2.5 mEq/L (Severe Toxicity)
Oliguria, seizures, rapid progression → coma → death.
How should lithium be taken?
In 2–3 doses per day.
What should patients maintain?
Fluid and sodium intake.
Why should dehydration be avoided?
It increases lithium levels, leading to toxicity.
What medications interact with lithium?
Diuretics, NSAIDs, anticholinergics.
Is lithium safe in pregnancy/lactation?
NO – Avoid in pregnancy & lactation.
Valproic Acid adverse effects
GI distress (N/V, indigestion), hepatotoxicity, pancreatitis, thrombocytopenia, teratogenesis, weight gain.
Lamotrigine adverse effects
Double/blurred vision, dizziness, headache, nausea/vomiting, skin rash, risk of cleft lip/palate in 1st trimester.
When should carbamazepine be given?
At bedtime (reduces CNS effects).
