bipolar drugs

Question 1

quetiapine (trade name) is….

class of drug?

Answer 1

seroquel

SGA

Question 2

lurasidone (trade name) is….
class of drug?

Answer 2

Latuda

SGA

Question 3

ziprasidone (trade name) is….

class of drug?

Answer 3

Geodon

SGA

Question 4

lamotrigine (trade name) is….

class of drug?

Answer 4

Lamictal

2nd gen anti-epileptic drug // phenyltriazine

Question 5

the rate of suicide with people with bipolar disorder is ____x the general poulaiton

Answer 5

10 times

Question 6

% prevalence worldwide of bipolar disorder

Answer 6

1%

Question 7

diagnostic difficulties with bipolar disorder

Question 8

who was the first person to use lithium for mania? what observation led to this use?

Answer 8

John Cade; seeing the lethagry it produced in rats

Question 9

what was lithium originally used for?

Answer 9

gout , headaches, as a salt subsitute

Question 10

TI for lithium

Answer 10

TI: 1.25-2.5 (very narrow)

basically will kill you by causing kidney failure

Question 11

lithium side effects?

Answer 11

Neurological – tremor, lethargy, impaired concentration, dizziness, muscle weakness, nystagmus (repetitive, uncontrolled movement of eyes)

GI – nausea, vomiting, diarrhea, pain. Weight gain can be substantial.

Skin – rash, acne, psoriasis, hair loss, mucosal lesions, brittle nails

Thyroid – enlargement, goiter

Kidneys – increased thirst, increased urine output, renal failure

Cardiovascular – arrythmia

Question 12

nystagmus is…..
this is associated with what drug?

Answer 12

(repetitive, uncontrolled movement of eyes)

SE of lithium

Question 13

examples of anticonvulsants

Answer 13

Valproic Acid (valproate, Depakote)
Carbamazepine (Tegretol)
Oxcarbazepine (Trileptol)
Lamotrigine (Lamictal)
Gabapentin (Neurontin)
Pregabalin (Lyrica)
Topiramate (Topamax)
Zonisamide (Zonegran)
Tiagabine/retigabine

Question 14

issues with anticonvulsants

Answer 14

teratogenic
inc suicidality

Question 15

valproate (drug class and trade name)

Answer 15

depakote
anticonvulsant

Question 16

**Valproate is better for _____ than lithium

Answer 16

mixed episodes

Question 17

carbamazepine (trade name)

class of drug?

Answer 17

Tegretol

anticonvulsant

Question 18

carbamazepine SE

most serious SE?

Answer 18

Side effects: cognitive impairments, GI upset, sedation, motor ataxia, leucopenia/agranulocytosis, skin reactions

most serious: leucopenia/agranulocytosis

Question 19

carbamazepine may be better than lithium for ______

Answer 19

rapid cyclers / mixed mania

Question 20

oxcarbazepine (trade name)

Answer 20

trileptal

Question 21

benefits of oxcarbezpine

Answer 21

Better safety index; no GI issues, no alterations in liver enzymes (fewer drug interactions), no leucopenia (no monitoring required)

Question 22

gabapentin / pregabalin (trade)

Answer 22

Neurontin, Lyrica

Question 23

benefits of gabapentin / pregabalin

Answer 23

Excellent safety profile; not metabolized by liver, excreted intact

Question 24

what was topiramate originally developed for?

Answer 24

anti-diabetes

Question 25

topiramate trade name

Answer 25

topamax

Question 26

benefits / considerations for topiramate?

Answer 26

Not super useful as a txt for BD, per se, however induces weight loss, which can counteract weight gain seen with other BD drugs May increase lithium concentration in blood, so must monitor closely

Question 27

common atypical antipsychotics

Answer 27

risperidone (Risperdal) olanzapine (Zyprexa) olanzapine + fluoxetine = Symbyax quetiapine (Seroquel) aripiprazole (Abilify) ziprasidone (Geodon) lurasidone (Latuda)

Question 28

what is the first line of tmt for bipolar d/o?

Answer 28

atypical antipsychotics

Question 29

ability to reduce mania is correlated to________

Answer 29

affinity for D2 receptors

Question 30

STEP-BD study

Answer 30

~50% pxts achieved recovery, and ~50% of those pxts relapsed within 2 years Residual symptoms at recovery, concurrent psychiatric diagnoses Addition of an antidepressant did not give significantly better recovery rates Valproate not recommended for female pxts (PCOS, teratogenic) Lamotrigine is good for txt-resistant pxts Psychosocial txt is very important for optimal recovery

Question 31

The uncontrollable movements of muscles commonly in the limbs, face, and tongue produced by ACUTE treatment with antipsychotics are called

Answer 31

dystonia

Question 32

risperidone trade name drug class

Answer 32

(Risperdal) SGA

Question 33

olanzapine trade name drug class

Answer 33

(Zyprexa) SGA

Question 34

Valproic Acid trade name class?

Answer 34

(valproate, Depakote) anticonvulsant

Question 35

Carbamazepine trade name? drug class?

Answer 35

(Tegretol) anticonvulsant

Question 36

Topiramate trade name? drug class?

Answer 36

(Topamax) anticonvulsant

Question 37

dystonia is....

Answer 37

The uncontrollable movements of muscles commonly in the limbs, face, and tongue produced by ACUTE treatment with antipsychotics