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
