bipolar/mania (2)

Question 1

describe duration of mania for classification

Answer 1

lasts at least 1 week for most of the day nearly every day

Question 2

describe alterations that classify mania?

Answer 2

elevated, expansive, irritable, increased activity or energy, goal oriented

Question 3

what is the hallamrk of mania?

Answer 3

flight of ideas

Question 4

what are some of the signs/sx of mania?

Answer 4

-grandiosity
-decreased need for sleep
-more talkative
-flight of ideas
-distractibility
-goal-oriented
-psychomotor agitation
-excessive involvement

Question 5

how can mania be emeregnt

Answer 5

increased suicide risk

Question 6

can mania be attributed to substances or other conditions?

Answer 6

no

Question 7

describe hypomania

Answer 7

less severe than regular/severe mania
-euphoric/increases functioning
-excessive activity
-not severe enough ti impair functioning or require hospitalization
-no psychosis with mania, may be present in depression

Question 8

what disorders are characterized by mood swings from profound depression to extreme euphoria with intermittent periods of normalcy

Answer 8

bipolar disorders

Question 9

what are the 3 types of bipolar disorders

Answer 9

bipolar 1
bipolar 2
cyclothymic

Question 10

which bipolar disorder has a full syndrome of manic symptoms, alternates depression with anxiety and agitation, psychosis possible

Answer 10

bipolar 1

Question 11

comorbidities with bipolar 1

Answer 11

anxiety, ADHD, impulse control, substance use

Question 12

which bipolar disorder is major depression with episodic occurence of hypomania, has never met criteria for full manic episode

Answer 12

bipolar 2

Question 13

comorbidities with bipolar 2

Answer 13

anxiety, eating disorders, subsyances

Question 14

which bipolar disorder has symptoms of hypomania alternating with mild/moderate depressin for at least 2 years, does not meet other criteria - yet disturbing enough to alternate functioning

Answer 14

cyclothymic disorder

Question 15

comorbidities with cyclothymic disorder

Answer 15

substance use disorder, sleep disorder, ADHD

Question 16

describe rapid cycling in bipoalr disorder

Answer 16

4 mood episodes in 12 months, more severe and resistant to treament

Question 17

bipolar used to be highly diagnosed in kids, but now is not. what is it called in kids now?

Answer 17

disruptive mood dysregualtion disorder (DMDD)

Question 18

what is there a high risk for in undiagnosed bipolar teens?

Answer 18

suicide

Question 19

is bipolar hereditary?

Answer 19

yes

Question 20

biochemical influences of bipolar

Answer 20

excess norepi & dopamine, low serotonin
too much acetylcholine in depression, not enough in mania

Question 21

what is lithium carbonate used for

Answer 21

antimanic, neuroprotective antisuicidal

Question 22

contraindications of lithium

Answer 22

sodium depletion, dehydration, cardiac/renal disease, pregnancy/lactation

Question 23

expected side effects of lithium

Answer 23

drowzy/dizzy/headache
dry mouth/GI upset
tremors
polyuria/dehydration
weight gain

Question 24

what is the therapeutic range of lithium

Answer 24

0.6-1.2 mEq/L

Question 25

at what level can lithium toxicity begin to be seen

Answer 25

1.5 mEq/L (HOLD MED AND CALL DR)

Question 26

at what lithium level should a patient be hospitalized

Answer 26

2.0-2.5

Question 27

describe fine tremors

Answer 27

expected, usually in hands, usually symmetric, can improve spontaneously

Question 28

describe coarse tremors

Answer 28

SIGN OF TOXICITY, more irregular and severe, widespread, associated woth other symptoms

Question 29

treatment of tremor

Answer 29

reduce caffeine, keep lithium levels low/medium, propranolol (beta blocker, HR/BP), vitamin B6

Question 30

what does a person on lithium need to regularly intake

Answer 30

Na (salt) 2g

Question 31

fluid intake for someone on lithium

Answer 31

1500-3000

Question 32

what can anticonvulsants be used for?

Answer 32

mood stabilizers

Question 33

what are the 3 main anticonvulsants used for mood stabilizers

Answer 33

valproic acid (depakene) / divalproex sodium (depakote) lamotrigine (lamictal)

Question 34

major side effect of anticonvulsants as mood stabilizers

Answer 34

liver failure

Question 35

BBW for anticonvulsants as mood stabilizers

Answer 35

increased risk for suicidal thoughts and behaviors

Question 36

therapeutic level of valproic acid

Answer 36

50-100 mcg/ml

Question 37

at what level is valproic acid toxic

Answer 37

above 100 mcg/ml

Question 38

BBW valproic acid

Answer 38

hepatotoxicity (monitor LFT/PLT)

Question 39

what is the life threatening complication that comes from lamotrigine

Answer 39

rash, steven johnson syndrome

Question 40

which meds work faster than mood stabilizers, so are used initially until drugs kick in

Answer 40

antipsychotics

Question 41

what combo of meds must be given for bipolar depression

Answer 41

antidepressant and mood stabilizer

Question 42

when monotherapy fails, what do yo udo?

Answer 42

augmentation with second med

Question 43

when is ECT used for mania

Answer 43

meds are not tolerated or when life threatening behavior is present, depressive episodes with catatonia

Question 44

what kinds of foods are best for manic patients

Answer 44

finger foods

Question 45

what is a good way of controlling manic behavior

Answer 45

distraction