CNS Bipolar/Antipsychotics Flashcards
(22 cards)
What are the two main types of mood episodes in bipolar disorders?
Manic episodes and depressive episodes
List symptoms of acute mania.
- Labile moods
- Flight of ideas, racing thoughts
What is the primary medication used as an antimanic agent?
Lithium
What is the moa lithium?
- Alters sodium transport in nerve and muscle
- Potentates reuptake of serotonergic neurotransmission
What is a black box warning associated with lithium?
Lithium toxicity is closely related to serum lithium levels and can occur at doses close to therapeutic levels
What are early signs of lithium toxicity?
- Diarrhea
- Vomiting
- Drowsiness
- Muscular weakness
- Incoordination
What are later signs of lithium toxicity?
- Giddiness
- Ataxia
- Blurred vision
- Tinnitus
- Increased urine output that is dilute
True or False: There is an antidote for lithium toxicity.
False
What are some side effects of lithium?
- Lithium Toxicity
- Hyponatremia
- Tremor
- Polyuria and thirst
- Dysrhythmias
What are contraindications for lithium use?
- Dehydration/Hyponatremia
- Severe renal and cardiovascular disease
What should be monitored when administering lithium?
- Lithium levels
- Sodium levels
What is a significant consideration regarding lithium for children?
Not recommended for children <12
What is the therapeutic effect timeframe for lithium?
1-3 weeks
What is the first-generation antipsychotic medication mentioned?
Haloperidol (Haldol)
What are the indications for first-generation antipsychotics?
- Schizophrenia
- Manic states
- Psychoses – acute or chronic
What is the action of first-generation antipsychotics?
- Alters the effects of dopamine in the CNS
- Has significant anticholinergic and alpha-adrenergic blocking activity
What are common side effects of first-generation antipsychotics?
- Acute Extra Pyramidal Symptoms (EPS)
- Sleepiness
- Sedation
- Dry mouth, dry eyes, blurred vision, constipation, urinary retention
- Orthostatic hypotension
- Agranulocytosis
- Weight gain
What is neuroleptic malignant syndrome (NMS)?
A severe, but rare EPS characterized by muscle rigidity, hyperthermia, and autonomic dysfunction
What teaching points should be provided for patients taking first-generation antipsychotics?
- Monitor for EPS and NMS
- Take with food
- Stress medication compliance
- Get up slowly
- Avoid temperature extremes
- Encourage good oral hygiene
- Avoid alcohol or other CNS depressants
Name some second-generation antipsychotic medications.
- Clozaril (clozapine)
- Risperdal (risperidone)
- Zyprexa (olanzapine)
- Seroquel (quetiapine)
- Abilify (aripiprazole)
What are common side effects of second-generation antipsychotics?
- Hyperglycemia
- Hyperlipidemia
- Weight gain
- Sedation
- Orthostatic hypotension
- Prolonged QT intervals
- EPS and NMS
What precautions should be taken with atypical antipsychotics?
- Avoid activities requiring mental alertness if dizziness occurs
- Avoid use with CNS depressants
- Avoid abrupt withdrawal
- Monitor blood pressure
- Monitor blood glucose
