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S3 Ross Pharm Bipolar and Mania
Turnbill
17
Pharmacology
Professional
11/17/2009

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Cards

Term
A light alkali metal available in carbonate slow-release, and controlled-release forms.
Definition
Lithum. It replaces sodium in the body.
Term
What is a fast cycler?
Definition
Has more then 3 bipolar cycles/year. This is then treated with antiepileptics NOT lithium
Term
Neuroleptics =
Definition
antipsychotics = antischizophrenics
Term
Lithium is used for..
Definition
The PROPHYLAXIS of recurring relapsing mania. Manic depressives, recurrent depression. Treatment of aggressive or self-mutilating behavior. Prophylaxis of schizoaffective disorder in COMBINATION withan antipsychotic depot prep.
Term
What does lithium do different from sodium in neurons?
Definition
Lithium can support a single action potential. It cannot maintain membrane potentials due to inadequate concentration gradient. This proves to be toxic to nervous tissues so it has a very narrow therapeutic index.
Term
What are some components of a Pre Lithium work up?
Definition
Creatinine, BUN, Urine specific gravity, electrolytes and lithium, ECG, CBC + Differential, T4, TSH, Pregnancy.
Term
Why might Lithium not be a good idea for children or adolescents?
Definition
Li may substitute for Na+ in bone which can leads to structural problems. Bones must be monitored.
Term
Why do you co-administer Lithium with CPZ?
Definition
The full therapeutic effect takes weeks to establish so chlorpromazine is given to fix the manic issue until the Li kicks in.
Term
MOA of Lithium. Note Turnbull will not test this because it is not well understood.
Definition
1. Decreased post-synaptic receptor sensitivity. 2. Stimulates Na+ exit from cells. 3. INHIBITS cAMP AND IP3
Term
Common adverse effects of lithium.
Definition
Initially N/V/D. Xerostomia. FIND HAND TREMOR. WEIGHT GAIN. THIRST. DIABETES INSIPIDUS. GOITER.
Term
Some toxic symptoms of Lithium.
Definition
Renewal of N/V/D. Coarse tremor. Ataxia. Albuminura. ACUTE INTERSTITIAL NEPHRITIS.
Term
Why is Lithium contraindicated in patients with Sick Sinus Syndrome?
Definition
It will cover up sinus bradycardia, SA Block, or Wenckebach.
Term
What are the alternatives to Lithium? Very Good and Calm?
Definition
Valproate, Carbamazepine, Gabapentin. Also Lamotrigine
Term
What type of bipolar patient would you prescribe alternatives to lithium?
Definition
Rapid cyclers.
Term
Describe the adverse effects and toxicity of lithium. Hint the answer is a picture.
Definition
[image]
Term
What hormone should be monitored during lithium use?
Definition
TSH. Lithium may cause hypothyroidism.
Term
How would you treat lithium toxicity?
Definition
Diuretics. Do NOT use thiazides because they will INCREASE the plasma levels of the drug. You can also use sodium bicarb.
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