bipolarFC

Question 1

What monitoring for Lithium?

Answer 1

CBC (plasma levels), Renal (Renal changes over time-Nephrotoxicity), Thyroid (Decreased thyroids function over time)

Question 2

What initial side effects do you see with the use of Lithium?

Answer 2

GI distress, fine hand tremor, Inability to concentrate urine.

Question 3

What agent is useful in lithium-refractory patients, rapid cycling and mixed episodes, as well as useful in acute mania, with efficacy close to lithium?

Answer 3

Carbemazepine

Question 4

This agent is more effective than lithium in controlling rapid cycling, mixed statesm and comorbid substance abuse, and is often used in combination with lithium to treat refractory rapid cycling and mixed states?

Answer 4

VPA

Question 5

Bipolar 1 is characterized by what types of episodes predominately?

Answer 5

Manic

Question 6

Bipolar 2 is characterized by what types of episodes predominately?

Answer 6

Depressive

Question 7

Approximately how many percent of bipolar patients discontinue pharmacological therapy?

Answer 7

50

Question 8

How many months must pass for a patient to be in remission?

Answer 8

6

Question 9

What is the preferred agent for treating euphoric mania?

Answer 9

Lithium

Question 10

What is the preferred agent used for treatment of irritable mania, mixed, rapid cycling episodes?

Answer 10

Divalproex Sodium

Question 11

What agent must be scheduled for acute episodes of mania, and DCed after symptoms begin to respond?

Answer 11

CBZ, OXC

Question 12

Which agent is in a sublingual twice daily dose that requires the patient to not drink or eat for 10 minutes after administration?

Answer 12

Asenapine (Saphris)

Question 13

What is used for the treatment of psychotic mania, and aggression?

Answer 13

Antipsychotics

Question 14

What are the antipsychotics used in acute mania?

Answer 14

Aripiprazole, Olanzapine, Quetiapine, Risperidone, Ziprasodone

Question 15

What antipsychotic is used for refractory cases (more than 2 agents tried) of acute mania?

Answer 15

Clozapine

Question 16

What is the severe SE associated with Clozapine?

Answer 16

Agranulocytosis

Question 17

What are the common side effects of antipsychotics?

Answer 17

Weight gain, Sedation, Diabetes, metabolic syndrome

Question 18

At what level of lithium will a patient be needed to put on dialysis?

Answer 18

2

Question 19

What is the normal level range of lithium?

Answer 19

0.8 - 1

Question 20

What is the therapeutic level range of Divalproex Sodium?

Answer 20

50-125

Question 21

What are the characteristic side effects of Divalproex sodium?

Answer 21

Hyperammonia, Hypothyroid, and Thrombocytopenia

Question 22

What is the only antipsychotic available that you can use as a monotherapy for depression?

Answer 22

Quetiapine

Question 23

What is the common SE profile of second generation antipsychotics?

Answer 23

Movement disorders, sedation, orthostatic hypotension, Constipation, Metabolic syndrome

Question 24

What are the FDA approved agents used in pediatric mania?

Answer 24

Risperidone, Aripiprazole

Question 25

What are the preferred first line agents for an acute depressive episode?

Answer 25

Lithium, Quetiapine

Question 26

What is the characteristic side effect associated with Lamotrigine (Lamictal)?

Answer 26

SJS-Rash

Question 27

What woud you add to a lithium treatment if a patient is having a psychotic depression?

Answer 27

Lamotrigine, divalproex sodium

Question 28

Which agent's dose needs to be halved when taking with VPA?

Answer 28

Lamotrigine

Question 29

What benzo can be used in refractory cases of depression?

Answer 29

Carbemazepine

Question 30

What is the preferred class of antidepressants?

Answer 30

SSRI

Question 31

What is the most common side effect of Olanzapine (Zyprexa)?

Answer 31

Weight gain

Question 32

What is the most common side effect of Quetiapine (Seroquel)?

Answer 32

Sedation

Question 33

What is the most common side effect of Risperidone (Risperdal)?

Answer 33

EPS

Question 34

What is the most common side effect of Ziprasidone (Geodon)?

Answer 34

QT prolongation

Question 35

Which adjunct agent is useful in concomitant anxiety or pain conditions?

Answer 35

Gabapentin, Pregbalin

Question 36

Which bipolar agent is the only agent that requires thyroid function monitoring?

Answer 36

Lithium

Question 37

What monitoring parameters are needed for Divalproex sodium?

Answer 37

LFT< CBC

Question 38

What monitoring parameters are needed for Lamotrigine?

Answer 38

none, look out for SJS-rash

Question 39

What monitoring parameters are needed for CBZ?

Answer 39

CMP, LFT, CBC

Question 40

What monitoring parameters are needed for OXC?

Answer 40

CMP, LFT

Question 41

depakene

Answer 41

valproate

Question 42

stavzor

Answer 42

valproate

Question 43

depacon

Answer 43

valproate

Question 44

depakote

Answer 44

divalproex

Question 45

lamictal

Answer 45

amotricgine

Question 46

lithobid

Answer 46

lithium

Question 47

abilify

Answer 47

aripiprazol

Question 48

seroquel

Answer 48

quetiapine

Question 49

symbyax

Answer 49

olanzapine/fluoxetine

Question 50

ripserdal

Answer 50

risperadone

Question 51

geodone

Answer 51

ziprasadone