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HLSC 220 - Pharmacotherapeutics for Healthcare Professionals > Chapter 36 - Drugs for Bipolar Disorder > Flashcards

Chapter 36 - Drugs for Bipolar Disorder Flashcards

(56 cards)

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1
Q

Are there gender differences in the stats of bipolar disorder?

A

no

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2
Q

What is bipolar disorder?

A

a cyclic disorder involving fluctuations in mood between mania and depression

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3
Q

What are the anxious distress symptoms of bipolar disorder?

A

-tension
-restlessness
-difficulty concentration
-constant worry
-feeling out of control

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4
Q

What are the mixed features of bipolar disorder?

A

meeting criteria for manic or hypomanic episode but having depression symptoms at the same time

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5
Q

What are the melancholic features of bipolar disorder?

A

loss of pleasure in all or most activities, not feeling better when something good happens

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6
Q

What are the atypical features of bipolar disorder?

A

-symptoms not typical of a depressive episode
-improved mood when something good happens

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7
Q

Peripartum Onset

A

bipolar symptoms that occur during pregnancy or in the four weeks after delivery

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8
Q

Seasonal Pattern

A

lifetime pattern of manic, hypomanic, or depression that change with seasons

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9
Q

Rapid Cycling

A

having four+ mood swing episodes in a single year with periods of remission in between

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10
Q

Psychosis

A

severe episode of mania or depression that results in detachment from reality and includes delusions or hallucinations

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11
Q

Catatonia

A

not reacting to your environment, holding your body in an unusual position, not speaking, or mimicking speech or movement

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12
Q

Bipolar I Disorder

A

-have at least one manic episode
-episode is followed by hypomanic or major depressive episode
-mania causes psychosis

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13
Q

Bipolar II Disorder

A

-have at least on major depressive episode lasting at least 2 weeks
-at least one hypomanic episode lasting at least 4 days
-NEVER HAD A MANIC OR MIXED EPISODE

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14
Q

Cyclothymic Disorder

A

-at least 2 years (1 year in children) of hypomanic symptoms (not episode) and periods of depressive symptoms (not episode)

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15
Q

Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, and risperidone alone or in combo are first-line treatments for ______ _______ (CANMAT).

A

acute mania

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16
Q

Quetiapine, lurasidone plue lithium or divalproex, lamotrigine, lurasidone are all first line options for ________ ___ ________ (CANMAT).

A

bipolar I depression

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17
Q

What are some examples of mood stabilizers?

A

-lithium
-divalproex sodium
-carbamazepine

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18
Q

What are mood stabilizers used for?

A

-relieving symptoms during manic and depressive episodes
-preventing recurrence of episodes
-do not worsen symptoms or accelerate cycling

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19
Q

When are antipsychotics given for bipolar disorder?

A

severe manic episodes

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20
Q

When are antidepressants given for bipolar disorder?

A

depressive episodes

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21
Q

Lithium + Valproate + Antipsychotic are used for…

A

short-term therapy of MANIC episodes

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22
Q

Lithium or Valproate, Bupropion, Venlafaxine, or a SSRI, and certain antipsychotics are used for…

A

short-term therapy of DEPRESSIVE episodes

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23
Q

What lifestyle changes are important for bipolar disorder?

Study These Flashcards
A

-avoid substance use
-sleep
-monitor mood
-stress reduction
-regular activity

24
Q

What are other nondrug therapies for bipolar disorder?

Study These Flashcards
A

-psychotherapy
-ECT (not 1st choice)

25
What drug class is lithium?
mood stabilizer
26
How does Lithium act (supposedly)?
-alter ion distribution -alter synthesis and release of 5-HT, DA, and NE -affects second messengers (cAMP) -alters glutamate uptake and release -block 5-HT binding -inhibit glycogen synthesis
27
Lithium can be used as an adjunct drug for?
-schizophrenia -depression
28
Lithium has a ______ half-life
short
29
Lithium excretion is ________ when sodium levels are low (and vv)
reduced
30
Lithium has a ________ therapeutic index
narrow
31
What is the maintenance lithium plasma level?
0.6-1.0 mmol/L
32
What is the acute lithium plasma level?
0.8-1.2 mmol/L
33
What is the elderly lithium plasma level?
0.4-0.7 mmol/L
34
What lab values MUST be done before starting lithium?
-electrolytes -renal and hepatic function -ECG -thyroid function -pregnancy test
35
What are the AEs of lithium in a therapeutic level?
-N&V -diarrhea -hand tremor -polyuria -thirst -renal toxicity -goiter -hypothyroidism -teratogenic -alopecia -acne -weight gain
36
What are the symptoms of lithium toxicity in the 1.5-2.0 mmol/L range?
-drowsy -ataxia -tremor -slurred speech
37
What are the symptoms of lithium toxicity in the >2.0 mmol/L range?
-arrythmias -seizures -bradycardia -myocarditis -coma -death
38
What is the antidote for lithium toxicity?
none.
39
What does Lithium interact with?
-diuretics -NSAIDs -ACEIs -ARBs -caffeine -sodium
40
Therapeutic effects of lithium can take up to ___ weeks.
3
41
How do you minimize GI effects of lithium?
give with food
42
Antiepileptic drugs can also be used as...
mood stabilizers
43
What is Divalproex (Valproic acid) used for?
-bipolar disorders -seizure disorders -migraines
44
What does Divalproex interact with?
lamotrigine
45
Is Divalproex safe during pregnancy?
no - teratogenic
46
How is carbamazepine (Tegretol) administered?
-chewtab -tablet -suspension -CR
47
What is a major AE of carbamazepine and lamotrigine?
Stevens-Johnson syndrome
48
What is carbamazepine used for?
-seizures -bipolar disorder -trigeminal neuralgia
49
The dose of Lamotrigine should be reduced with simultaneous use of ___________.
Divalproex
50
What is Lamotrigine used for?
long-term maintenance of bipolar disorder
51
What is Gabapentin used for?
-treatment of neuropathic pain -AED -anxiety
52
What are the adverse effects of Gabapentin?
-somnolence -weight gain -blurred vision
53
What are the adverse effects of Topirimate?
-cognitive dysfunction -paresthesia -kidney stones -less sweating -weight loss
54
Topiramate interacts with ____
OC's
55
What antipsychotics are approved for bipolar disorder?
-olanzapine -quetiapine (seroquel) -risperidone -aripiprazole -ziprasidone -lurasidone (depression) -cariprazine (mania)
56
Patients on Lithium must maintain a constant __________ intake
sodium

HLSC 220 - Pharmacotherapeutics for Healthcare Professionals (18 decks)

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