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Psychiatry > Mood Stabilizers > Flashcards

Mood Stabilizers Flashcards

1
Q

Mood stabilizers are used to tx =

A

Acute Mania

Prevent relapses of manic episodes

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2
Q

2º indications for mood stabilizers =

A
  • Potentiation of antidepressants in patients with major depression refractory to mono therapy
  • Potentiation of antipsychotics
  • Enhancement of abstinence in EtOH tx
  • Treatment of aggression and impulsivity
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3
Q

Drug of choice for mania =

A

Lithium

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4
Q

Indications for Lithium =

A
  • Bipolar Disorder
  • Cyclothymia
  • Unipolar depression
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5
Q

Metabolism site for lithium =

A

Kidney

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6
Q

Tests which should be performed before patient started on Lithium =

A
  • ECG
  • Basic Chemistries
  • Thyroid function tests
  • CBC
  • Pregnancy Test
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7
Q

Onset of action of Li =

A

1 week

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8
Q

Blood levels of Li correlate with efficacy?

A

Yes, therefore you should always check the blood levels and titrate to a therapeutic level

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9
Q

Drawback of Li =

A
  • Side effects

- Narrow therapeutic index

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10
Q

Side effects of Li =

A
  • Death
  • B9 Leukocytosis
  • AMS
  • Course tremors
  • Convulsions
  • Fine tremor
  • Nephrogenic diabetes insipidus
  • GI disturbance
  • Weight gain
  • Sedation
  • ECG changes
  • Ebstein’s Anomaly
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11
Q

Ebstein’s Anomaly =

A

Cardiac defect in newborns in mothers who have taken Li

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12
Q

Indications for Carbamazepine =

A
  • Mixed episodes of mania and depression
  • Rapid-cycling bipolar disorder
  • Trigeminal Neuralgia
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13
Q

MOA of carbamazepine =

A

Blocking Na channels and inhibiting action potentials

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14
Q

Onset of action of carbamazepine =

A

1 week

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15
Q

What must be obtained and monitored continuously if a ptn receive carbamazepine =

A
  • CBC

- LFTs

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16
Q

Carbamazepine side effects =

A
  • GI sx
  • CNS depression
  • Steven-Johnson Syndrome
  • Leukopenia
  • Hyponatremia
  • Aplastic anemia
  • Thrombocytopenia
  • Agranulocytosis
  • Hepatitis
  • Tetratogen
17
Q

Carbamazepine metabolism features =

A
  • Many drug interactions with cytP450 drugs

- Autoinduces its own metabolism

18
Q

Signs of carbamazepine toxicity =

A
  • Confusion
  • Stupor
  • Motor restlessness
  • Nystagmus
19
Q

Indications for valproic acid =

A
  • Bipolar Disorder

- Rapid cycling bipolar disorder

20
Q

What to monitor with valproic acid =

A

CBC

LFTs

21
Q

Lamotrigine

  • Class =
  • MOA =
  • Indications =
  • Side effects =
  • Important drug interactions =
A

Class:
- Anticonvulsant / Mood stabilizer

MOA:
- Sodium channels modulating glutamate and aspartate

Indications:
- Bipolar DEPRESSION

Side Effects:

  • Steven Johnson Syndrome
  • Dizziness
  • Sedation
  • Headaches

Drug Interactions:

  • Lamotrigine decreases valproate levels
  • Valproate increases Lamotrigine levels
22
Q

How to avoid Steven Johnson Syndrome =

A

Start on low doses of the medication and titrate up slowly

23
Q

Oxcarbazepine

  • Class
  • Perks
A

Class =
- Mood stabilizer and anticonvulsant

Perks =

  • Better mood stabilizer than carbamazepine
  • Less hepatic toxicity and rash than carbamazepine
24
Q

Gabapentin

  • Class
  • Indications
A

Class:
- Anticonvulsant / Mood stabilizer

Indications:

  • Adjunctively to help with sleep and anxiety
  • No good for bipolar disorder
25
Q

Pregabalin

  • Class
  • Indications
A

Class
- Anticonvulsant / Mood Stabilzer

Indications:

  • GAD
  • Fibromyalgia
  • No good for bipolar disorder
26
Q

Tiagabine

  • Class
  • Indications
A

Class = anticonvulsant / Mood stabilizer

Indications = Anxiety

27
Q

Topiramate

  • Class
  • Indications
  • Side effects
A

Class = anticonvulsant / Mood stabilizer

Indications:

  • Anxiety
  • Reduce cravings for alcohol
  • SSRI-refractory bulimia nervosa
  • Impulse control disorder

Side effects:

  • Cognitive Slowing
  • Weight Loss
  • Hypochloremic, non-anion gap metabolic acidosis
  • Kidney Stones
28
Q

Drug potentially causing pancreatitis =

A

Valproic Acid / Divalproex sodium

29
Q

Drug likely causing increased urination =

A

Lithium, since it can cause nephrogenic diabetes insipidus.

30
Q

Side effects of valproic acid?

A
  • Weight gain
  • Alopecia
  • Pancreatitis
  • Hepatotoxicity
  • Elevated ammonia
  • Thrombocytopenia
  • Neural tube defects

Psychiatry (14 decks)

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