Term
| What are the mood stabilizing agents? |
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Definition
Li
carbamazepine
valproate
lamotrigine
"Lithium calms volatile lunatics" |
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Term
| Lithium is what kind of drug? |
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Definition
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Term
| Carbamazepine is what kind of drug? |
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Definition
| Antiepileptic that is also a mood stabilizing agent |
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Term
| Valproate is what kind of drug? |
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Definition
| broad spectrum anticonvulsant that is also a mood stabilizing agent |
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Term
| Lamotrigine is what kind of drug? |
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Definition
| anti-convulsant which is also a mood stabilizing agent |
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Term
| Mechanism of Li:2 hypotheses |
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Definition
Berridge hypothesis: inhibits activity of a phosphatase that hydrolyzes inositol-2 (or 1-)-phosphate (IP2 and IP1)so that you never get myoinositol or PIP2 leading to decreased PLC2 (NTs and hormones that acty by activating PLC are reduced by Li)
Hypothesis two: AA cascade down regulation by downregulating phopholipase A2 transcription and inhibit COX2 |
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Term
| Why are peripheral organs less affected by Li? |
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Definition
| probably b/c they have extracellular sources of myoinositol whereas brain depends heavily on recycled myoinositol |
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Term
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Definition
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Term
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Definition
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Term
| Under what conditions is excretion of Li lowered? |
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Definition
| when Na+ reabsorption in proximal tubule is enhanced (80% of Li is absorbed here too); i.e. Na restriction, water depletion, hypovolemia, chronic diuretic use |
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Term
| What's the therapeutic index of Li like? |
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Definition
| low. manic dose is 1.2mEg/L; maintenance is .6 - .8; side effects appear at 1-1.5 mEq/L |
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Term
| Side effect profile of Li |
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Definition
GI distress
N, V, D
find hand tremor
muscle weakness
polyuria and edema
Cardiac toxicity: Li may produce QRS widenig and T wave flatenning (only concerning in preexisting cardiac problem)
Accumulation in Thyroid and lowering of T3 and T4
Renal toxicity: polyuria (and dipsia) can be massive |
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Term
| Drug drug interactions: Li |
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Definition
diuretics (Li reaborbed in proximal tubule)
tricyclics (anticholinergics) - urinary retention + polyuria = bad combo |
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Term
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Definition
acute tx of manic episode (w. antipsychotic or potent BDZ while it kicks in, takes 5-6 days to build up)
Prophylactic tx of manic depressives |
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Term
| How long does it take for carbamazepine to kick in w/ symptomatic relief? |
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Definition
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Term
| Mechanism of action: valproate |
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Definition
| impairs function of several voltage dependent ion channels (fast Na and low threshold Ca channels) |
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