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Mood stabilizers
mood
19
Medical
04/11/2013

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Cards

Term
Lithium
(Eskalith)
Advantages x 3
Definition
-Effective
-not typically associated with weight gain
-only mood stabilizer to decrease suicidality
Term
Lithium, test prior to starting x 5
Definition
-CBC
-EKG
-Preg test
-TFT
-BMP--kidney
Term
Lithium commen SEs x 7
Definition
-hyperkalemia, ekg
-polyuria
-polydipsia
-sedation
-tremor
-benign leukocytosis
-acne
Term
Lithium dangerous SEs
Definition
Nephrogenic DI, renal impairment
-thyroid dysfunction

hydrochlorothyazide and spiralactone increase lithium blood level
Term
Lithium onset of action
therapeutic leves
Definition
5-7 days
.6 to 1.2
toxic >1.5
lethal >2
Term
Lithium DDIs
Definition
diuretics and nsaids (ibuprofen)
Term
Other lithium SEs
Definition
n/v/d
tremor
ataxia
MS changes
renal failure
convulsions
coma
Term
Valproic acid
common SEs x 3
Definition
"Depakote"
-sedation
-weight gain
-alopecia
Term
VPA dangerous SEs x 2
Definition
hepatotoxicity
thrombocytopenia
Term
vpa advantage
Definition
slightly wider therapuetic window compared to lithium
Term
VPA disadvantages
Definition
-blood draws to monitor levels
-platelets
LFTs
-teratogenic
Term
VPA toxicities
Definition
-n/v
-ataxia
-eye movement abnormalities
-lethargy
-coma
Term
bipolar first line x4
Definition
-lithium
-lamotrigine
-olanzapine
-quetiapine
Term
bipolar 2nd line x 2
Definition
-VPA (Divalproex)
-apriprazole
Term
carbamazepine
Definition
"Tegretol"
-bone marrow suppression
-many drug interactions
P-450 inducer, induces own metabolism
OCP interaction, decrease OCP and teratogen
maybe Stevens Johnson
Term
carbamazepine
Definition
"tegretol"
-trigeminal neuralgia
-blocks sodium channel and inhibit action potential
-onset of action 5-7 days
-CBC and LFT check and monitor
Term
lamotrigine
Definition
"Lamictal"
-useful in bipolar depression
-must titrate slowly
-risk of Stevens-Johnson syndrome
Term
lamotrigine
Definition
decreases VPA levels and VPA increases Lamictal levels
Term
topiramate
Definition
"Topamax"
-can promote weight loss
-also for headaches
-Dopamax--cognitive SEs
-Kidney stones