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Bipolar
Bipolar
44
Pharmacology
Professional
03/14/2011

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Cards

Term
What is Cyclothymia?
Definition
2 years of cycling of depressive sx and hypomania
Term
T/F Lithium has a narrow TI
Definition
T
Term
Diagnostic criteria for BPD?
Definition
DIGFAST-Distractible, Insomnia, Grandiosity, Flight of ideas, Activity increased, Speech pressured, Thoughtlessness
Term
Rapid cycling is ____ distinct episodes in a period of_____
Definition
four or more, 12 mos.
Term
Which atypical antipsychotic didn't make it to the Bipolar Maintenance Party being held by the FDA?
Definition
Asenapine (also, iloperidone, lurasidone, and paliperidone)
Term
Which typical antipsychotic is FDA approved for Acute mania?
Definition
Haloperidol
Term
For the depressive portion of BPD, which drugs are approved?
Definition
Olanzapine+Fluoxetine, Quetiapine
Term
T/F Lithium is effective in the BPD subtypes
Definition
F
Term
The MoA of Lithium
Definition
modifies 5HT & NE synthesis/release, inhibits cAMP, alters D2 sensitivity
Term
T/F Lithium is protein bound and renally eliminated
Definition
False-it is 100% renally eliminated, but is NOT protein bound.
Term
What are Lithium's interactions?
Definition
TANSoX-Thiazides, ACEIs, NSAIDs, Sodium, Xanthines (first 3 increase Li, So may do either, Xanthines lower)
Term
What are indicators of poor Li response?
Definition
Rapid cycling and atypical features (hallucinations and delusions)
Term
What can be given for tremors resulting from Litium?
Definition
propranolol
Term
What pregnancy category is Lithium? What is the 1st trimester associated affliction?
Definition
D; Ebstein's abnormality
Term
Which drug can cause hypothyroidism? What is the tx?
Definition
Lithium; treat with T4(Levothyroxine)
Term
T/F Lithium will do the opposite of sodium in the renal tubules
Definition
false; Li FOLLOWS Na in the renal tubules.
Term
Lithium may take _____ for onset and _____ for full effect.
Definition
10-14 days; 1 month
Term
Valproic acid's on label use is ______ and off label use is ______
Definition
acute mania, BPD maintenance
Term
Lithium's uses are _____
Definition
acute mania and BPD maintenance
Term
When taking Valproic Acid and Lamotrigine, how must you adjust?
Definition
decrease lamotragine dose by 50%.
Term
What are VPA's BBW's?
Definition
Pancreatitis and hepatotoxicity
Term
T/F you should take VPA with food
Definition
F, food delays absorption
Term
T/F, VPA's PK is not affected by renal or hepatic disease.
Definition
F, Renal dx will DECREASE protein binding; Hepatic dx will result in more free drug.
Term
What are VPA's interactions?
Definition
LAWCaPS-Lamotrigine (rash), ASAs, Warfarin, CBZ, Phenytoin, SSRIs
Term
Which drug is good for Li refractory PTs, BPD subtypes, and substance abuse PTs?
Definition
Valproic Acid
Term
What is Valproic Acid's pregnancy cat? What defects can result in the case of pregnancy?
Definition
D; neural tube (eg, spina bifida)
Term
Which drug(s) regulates GABA and normalizes Na and Ca channels as an MoA?
Definition
VPA and Carbamazepine
Term
T/F, in acute mania, Carbamazepine is 2nd line
Definition
T
Term
T/F Carbamazepine is ideal for treatment due to its few drug interactions
Definition
False. It has many interactions and is an inducer and autoinducer of many cyp enzymes
Term
Which drug is used for maintenance and delays the occurrence of episodes?
Definition
Lamotrigine
Term
Which drug blocks NA/Ca channels, and modulates glutamate?
Definition
Lamotrigine
Term
Which drug may cause steven johnson's syndrome?
Definition
Lamotrigine
Term
Which drug displays antikindling effects? What are antikindling effects?
Definition
Lamotrigine; reduces rapid cycling and mixed states.
Term
T/F Lamotrigine should be titrated slowly
Definition
T
Term
What drugs may Lamotrigine interact with?
Definition
CBZ and contraceptives reduce levels; if with VPA, reduce dose by half and rash may result, possibly progressing to Steven Johnson
Term
which drug is weight neutral?
Definition
Lamotrigine
Term
T/F when treating depressive episodes with antidepressants, the drug should be discontinued after symptoms resolve.
Definition
T
Term
Which antidepressant is least likely to cause a switch to mania?
Definition
Bupropion.
Term
T/F Antipsychotics are first line as monotherapy
Definition
T
Term
T/F antipsychotics is not used on those showing antipsychotic symptoms
Definition
false; it is sometimes limited to those showing those symptoms.
Term
What 3 atypical antipsychotics taught are NOT used to treat BPD at all?
Definition
Lurasidone Iloperidone, Paliperidone
Term
T/F Antipsychotics all have equal efficacy in acute mania. the difference lies in the AE profiles.
Definition
T
Term
Which alternative med may be used in pregnancy?
Definition
CCBs.
Term
Which antipsychotic is not like the others when it comes to acute mania?
Definition
clozapine
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