Term
|
Definition
2 years of cycling of depressive sx and hypomania |
|
|
Term
T/F Lithium has a narrow TI |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
|
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
|
|
Term
What pregnancy category is Lithium? What is the 1st trimester associated affliction? |
|
Definition
|
|
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
|
|
Term
Valproic acid's on label use is ______ and off label use is ______ |
|
Definition
acute mania, BPD maintenance |
|
|
Term
|
Definition
acute mania and BPD maintenance |
|
|
Term
When taking Valproic Acid and Lamotrigine, how must you adjust? |
|
Definition
decrease lamotragine dose by 50%. |
|
|
Term
|
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
|
|
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
|
|
Term
T/F, in acute mania, Carbamazepine is 2nd line |
|
Definition
|
|
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
|
|
Term
Which drug blocks NA/Ca channels, and modulates glutamate? |
|
Definition
|
|
Term
Which drug may cause steven johnson's syndrome? |
|
Definition
|
|
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
|
|
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
|
|
Term
T/F when treating depressive episodes with antidepressants, the drug should be discontinued after symptoms resolve. |
|
Definition
|
|
Term
Which antidepressant is least likely to cause a switch to mania? |
|
Definition
|
|
Term
T/F Antipsychotics are first line as monotherapy |
|
Definition
|
|
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
|
|
Term
Which alternative med may be used in pregnancy? |
|
Definition
|
|
Term
Which antipsychotic is not like the others when it comes to acute mania? |
|
Definition
|
|