Pharm, Mood Stabilizers, Martin Flashcards Preview

Year 2 Psych exam I > Pharm, Mood Stabilizers, Martin > Flashcards

Flashcards in Pharm, Mood Stabilizers, Martin Deck (26):
1

Main drugs used for mood stabilization

lithium carbonate
valproate: valproic acid or divalproex
carbamazepine
lamotrigine
atypical antipsychotics

2

genetics bipolar disrder

first degree relatives 24x more likely to develop bipolar disorder

3

avg age onset bipolar disorder

21

4

manic episode

elevated expansive or irritable mood for more than 1 week,
present most of the day

5

criteria manic episode

3+:
distractible
talkative pressured speech
racing thoughts or flight of ideas
hyper-alert: no need for sleep
increased activity or psychomotor agitation
grandiose
hypersexual- risky acts

6

lithium given how

oral as lithium carbonate

7

variable effects of lithium

substitutes for Na
changes DA and 5-HT and Ach systems

8

lithium in phosphoinositide pathway

inhibits enzyme that converts IP2 to IP1 and IP1 to inositol
depletes PIP2 which is source for IP3 and DAG messaging

9

depletion PIP2 leads to

dec responsiveness to synaptic transmission for R which utilize phosphoinositie messaging

10

time course for effect on PIP2

2-3 weeks of lithium Tx

11

adverse effects lithium

tremor!
hypothyroidism
renal dysfunction: polyuria polydipsia
cardiac conduction problems
gastric distress
mild cognitive impairement
edema
weight gain

12

therapeutic window with lithium

very very small
must monitor plasma drug level when put on or change dose

13

what can increase lithium toxicity

dehydration

14

what can be used in adjunct with lithium

valproate
carbamazepine
lamotrigine
atypical antipsychotics (be careful)

15

first line Tx for bipolar

valproic acid used because faster onset than lithium and wider therapeutic window

16

how dos valproate work

inc GABA levels

17

problems with valproate

GI and hepatic
congenital neural tube defects
alopecia
increase polycystic ovarian syndrome in women 9x

18

how dose carabmazepine work

blockage vNaCh

19

adverse effects carbamazepine

aplastic anemia and agranulocytosis!!
hyonatremia, diplopia, ataxia, GI upset, sedation and weight gain

20

PK carbamazepine

autoinduction CYP

21

lamotrigine is used how in manic disorders

maintenance therapy

22

MOA lamotrigine

blocks Na or Ca Ch

23

adverse effects lamotrigine

dizziness, HA, diplopia GI upset, somnolence, skin rask *steven johnson syndrome*

24

when changing off lamotrigine

slow tapering is critical!!

25

what drugs modulate lamotrigine

valproate doubles its [ ]
carbamazepine halves its [ ]

26

major adverse effects of clozapine, olanzapine and quetiapine

weight gain!!
clozapine and olanzapine also can induce DM