Term
| What are the uses of Lithium |
|
Definition
Acute Mania, Maintenance
Cyclic/Resistant Depression
Combo with Antipsychotics |
|
|
Term
| What is the effect of Lithium on people without mental illness |
|
Definition
|
|
Term
| When is the half life of lithium increased |
|
Definition
Long-term use
Renal Dysfunction
Geriatric Patients
NSAID's, Diuretics, Ace-inhibitors |
|
|
Term
| What are the proposed mechanisms of Lithium |
|
Definition
Insitol Monophosphatase inhibition depleting inositol
Inhibit Adenylate Cyclase causing low TSH and low vasopression
Inhibit Glycogen Synthase Kinase: neurprotective |
|
|
Term
| How is polyuria treated with patients on Lithium |
|
Definition
| Amiloride or other diuretics |
|
|
Term
| What are the adverse effects of Li |
|
Definition
Toxicity: Tremor, decresed cognition, Ataxia, Sedation
Weight Gain
Ebstein's Anomaly in first trimester use
Derm Side Effects
Leukocytosis
Low TSH
Neprogenic Diabetes Insipidous
Tubulointerstitial Necrosis |
|
|
Term
| When does therapeudic lithium overdose typically occur |
|
Definition
| Diuretic use depletes Na, increasing Li reabsorption |
|
|
Term
| What are the treatment options for lithium overdose |
|
Definition
|
|
Term
| What are the interactions of Valproate and Carbamazepine |
|
Definition
Carbamazepine increases Valproate clearance
Valproate decreases Carbamazepine clearance |
|
|
Term
| What are the uses of Sodium Valproate |
|
Definition
Acute Mania, Maintenance
Generalized Seizures
Migraine Prophylaxis
Bipolar |
|
|
Term
| What is the mechanism of Valproate |
|
Definition
Increase GABA
Decrease Na Conductance
Increase K Conductance
Decrease Ca Conductance |
|
|
Term
| Adverse Effects of Valproate |
|
Definition
Weight Gain
Ataxia
Teratogenic: Neural Tube
Hepatotoxic: Children and Pre-existing disease
Platelet decrease |
|
|
Term
| What are the uses of Carbamazepine? |
|
Definition
2nd Line Acute MAnia, Maintenance
Partial or Tonic-Myoclonic Seizures
Trigeminal Neuralgia |
|
|
Term
| Mechanism of Carbamazepine |
|
Definition
| Use Dependent Inactivation of Na channels |
|
|
Term
| What are the drug interactions of Carbamazepine |
|
Definition
Microsomal Enzyme activation increasing metabolism of:
Primidone
Phenyltoin
Ethosuximide
Valproate |
|
|
Term
| What are the adverse effects of Carbamazepine? |
|
Definition
Incoordination, Ataxia, Slurred Speech, Drowsy
Teratogenic: Neural Tube
SiADH
Agranulocytosis or Aplastic Anemia if elderly with trigeminal neuralgia
|
|
|
Term
| What are the uses of Lamotrigine |
|
Definition
Maintenance of mania and Depression(uniquely effective on depression)
AED |
|
|
Term
| What is the mechanism of lamotrigine? |
|
Definition
| Use Dependent Inactivation of Na channels decreasing Aspartate and Glutamate release |
|
|
Term
| Adverse effects of Lamotrigine |
|
Definition
Stephen's Johnson Syndrome(Toxic Epidemal Necrosis) in Children
Valproate increases half life, and Carbamazepine decreases half life |
|
|
Term
| Use of atypical antipsychotics |
|
Definition
Acute Mania
Maintenance with Li
Schizophrenia
Dementia's |
|
|
Term
| How is the Acute Manic attack of bipolar typically treated pharmacologically |
|
Definition
Mild/Moderate: Li or Sodium Valproate or an Atypical Anti-psychotic
Moderate/Severe: Li or Sodium Valproate with an Atypical Anti-psychotic |
|
|
Term
| How is the Acute phase of depression in bipolar disorder typically treated pharmacologically |
|
Definition
Mild/Moderate: Li or Lamotrigine
Moderate/Severe: Li or Lamotrigine with an Antidepressant
Li and Lamotrigine
Olanzapine and Fluoxetine |
|
|
Term
| What are the signs of Lithium Toxicity |
|
Definition
Tremor
Sedation
Decreased Cognition
Incoordination |
|
|
