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Flashcards in Somatic Therapies III Deck (57)
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1

What are the two drugs approved for bipolar maintenance?

-Li
-Lamotrigine

2

What are the three drugs that are helpful for the depressive stage of bipolar disorder?

-Olanzapine
-Quetiapine
-Lurasidone

3

What is the onset of action of Li?

5-7 days

4

What organ metabolizes Li?

Renal

5

What is the WBC abnormality that can occur with Li use?

Demarginalization causing leukocytosis

6

True or false: Li is rapidly absorbed

True

7

What are the pharmacokinetics of Li?

Linear

8

What are the side effects of Li?

-Polyuria/polydipsia
-Acne
-Hypothyroidism

9

How often should Li levels be checked?

Monthly for 3 months, then q 3 months

10

What are the drugs that increase Li levels?

Na depleting diuretics

11

Where is Li reabsorbed in the kidney?

Proximal tubule

12

Long term use of Li can increase what lyte level?

Ca

13

What are the cognitive side effects of Li?

-Distractibility
-poor memory
-Confusion

14

What are the congenital effects of Li?

Ebstein cardiac anomaly

15

When does Li toxicity come into play?

1.5 levels and above

16

What is the treatment for Li toxicity?

Dialysis

17

When is divalproex used for bipolar?

Rapid cyclers

18

What is the MOA of divalproex?

Increase GABA by inhibiting degradation and stimulating synthesis

19

What organ metabolizes divalproex? What are the labs that are monitored?

-Hepatic
-LFTs, CBC

20

What are the teratogenic effects of divalproex?

NTDs

21

What are the side effects of divalproex?

-Toxic hepatitis
-Hair loss
-PCOS

22

What are the effects of divalproex in prego?

NTDs

23

What is the MOA and use of carbamazepine?

-Acute mania and bipolar
-Na channel blocker and GABA agonist

24

What is the major side effect of carbamazepine?

Aplastic anemia

25

What is the MOA and use of lamotrigine?

-Na channel blocker
-Seizures

26

What is the major side effect of lamotrigine? What must be done to prevent this?

-Steven-Johnson syndrome
-Start slow and titrate up

27

What is the role of topiramate and gabapentin in the treatment of bipolar disorder?

No evidence of efficacy

28

What are the three major first line drugs in the treatment of Bipolar disorder?

Li
Valproate
Lamotrigine

29

What is the role of SGAs in the treatment of bipolar disorder?

second line

30

What is considered an adequate trial of Li, valproate, or lamotrigine?

3-4 weeks