Term
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Definition
(b)Eskalith, Eskalith CR, Lithobid, Lithium citrate
Must wait 5 days to check trough
Acute mania: 1-1.2mEq/L
Serum Levels:
Acute Depression: 0.8-1mEq/L
Maintenance: 0.6-0.8mEq/L
TOXIC: > or = 1.5mEq/L
Renal Excreted
NVD, weight gain, tremor, sedation, thirst
Avoids SEs: Take with food, divide doses, switch to ER
Interactions: NSAIDS (use APAP and aspirin for pain), Caffeine
Monitoring: EKG, Thyroid Fxn, Renal Fxn, CBC w/ diff, urinalysis, pregnancy test
Counseling: Avoid sleep deprivation, drug levels are important, GI upset=take with food |
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Term
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Definition
(b)Depakote, Depakote Sprinkle Caps, Depakote ER, Depakene
Serum conc. correlate with antielleptic effect, NOT antimanic effect
Must wait 3 days to check trough
SEs: asthenia,dizziness, GI, somnolence, thrombocytopenia (DOSE RELATED)
BLACK BOX WARNING: Hepatotoxicity, Teratogenicity, Pancreatitis
Interactions: Lamotrigine (Divalproex increases lamotrigine by 100mg= Dogs increase love)--> decrease dose of lamotrigene by 100mg if giving together
Monitors: Pregnancy, Liver Fxn, Renal Fxn, CBC w/diff |
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Term
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Definition
(b)Carbatrol, Equatro, Tegretol, Tegretol XR
Therapeutic conc. correlate with antiepileptic effect NOT antimanic effect
Must wait 4 days to get trough
Met: CYP3A4 Autoinducer (t1/2 decreases overtime)
induces CYP1A2, CYP2C9, CYP2C19
SEs: Dizziness, drowsiness, NV, unstediness
BLACK BOX WARNING: Toxic Epidermal Necrolysis (TEN) & Steven Johnson's Syndrome (SJS), Aplastic Anemia & Agranulocytosis
Interactions: 3A4 inhibitors (grapefruit, clarithromycin, diltiazem), 3A4 inducers (Phenytoin, Phenobarbital, Rifampin)
CBZ decreases other drugs: Lamotrigine (inc. Lamotrigine dose by 400mg with given together), Oral contraceptives, Protease inhibitors
Monitoring: Preg, Liver Fxn, Electrolytes, CBC w/diff |
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Term
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Definition
(b) Trileptal
Structurally similar to Carbamazepine; 3rd option
SEs: dizziness, nausea, rash, headache
Warnings: Hyponatremia, TEN & SJS, suicidal ideation, rare agraulocytosis and aplastic anemia
Interactions: OXC induces CYP3A4/5 (decreases oral contraceptives)
Monitoring: Electrolytes, Pregnancy |
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Term
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Definition
(b) Lamictal, Lamictal CD, Lamictal ODT, Lamictal starter kits
SEs: dizziness, fatigue, headache, insomnia, nausea, rash
BLACK BOX WARNING: SJS & TEN (must follow recommended dose titration)
Interactions: Lamotrigine decreases levonorgestrel and oral contraceptives decrease lamotrigine
Monitoring: LFTS, Renal Fxn, Pregnancy |
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Term
| DSM5 Criteria for Manic Episode |
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Definition
Elevated, expansive, or irritable mood and persistenly increased goal-directed activity or energy lasting > or = to 1 week.
> or = to 3 symptoms if elevated/expansive, or 4 if irritable
(DIGFAST)
-Distractibilty
-Infalted Self-Esteem
-Goal directed activity
-Flight of ideas
-Activities with painful consequences
-Sleep need is decreased
-Talkativeness
**If symptoms are severe enough for hospitalization, DO NOT have to display symptoms for 1 week**
> or= 1 manic episode is required to receive BPAD1 Dx |
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Term
| DSM5 Criteria for Depressed Episode |
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Definition
> or = 5 symptoms for at least 2 weeks. (At least 1 symptom MUST be anhedonia or depressed mood)
(SIGEDCAPS)
-Suicidal ideation
-Interest lost (anhedonia)
-Guilt
-Energy loss
-Depressed modd
-Concentration impairment
-Appetite changes
-Psychomotor changes
-Sleep changes |
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Term
| DSM5 Criteria for Bipolar II Disorder |
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Definition
Criteria has been met for
> or = 1 hypomanic
AND
> or = 1 depressive episode
Hypomanic episode
-Elevated, expansive or irritable mood lasting 4-7 days
-Need 3 symptoms of mania or 4 if irritable
-If psychosis is present, they automatically qualify as having manic episode regardless of time |
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