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Naplex

Bipolar Disorder

QuestionAnswer
Q1. Bipolar Disorder's types • Bipolar I (More server): Mania, May be psychotic/delusional and may require hospitalization. • Bipolar II: Hypomania, bouts of major depressive disorder
Q2, Mania vs Psychosis Mania: Hưng cảm Psychosis: loạn thần
Q3. Bipolar stages • Mania • MMD
Q4. Acute treatment - Manic episode • Antipsychotic: olanzapine • Lithium, Valproate • Server: Antipsychotics + Lithium or Valproate
Q5. Acute treatment - Depressive episodes • Antipsychotic: Quentiapine Added or alternatives: • Lithium, Valproate, Lamotrigine
Q6. Maitenance treatment • Lithium • Antiseizure, SGAs
Q7. Require Medguides for • Antidepression: suicide idea • ASMs: risk of dealth in elderly pt w dementia
Q8. Antiseizures • Lamotrigine (Lamictal): rash • Valproate/Valproic Acid Derivatives (Depakene, Depakote) • Carbamazepine (Equetro)
Q9. SGAs • Aripiprazole • Olanzapine • Quetiapine • Risperidone • Ziprasidone • Lurasidone
Q10. Lithium (Lithobid) • Therapeutic range: 0.6 - 1.2 mEq/L (trough level) • Acute mania: up to 1.5mEq • Start: 300-900mg divided BID-TID; range: 900-1800mg/d
Q11. Lithium (Lithobid) warnings • Renal impairment • HyPOnatremia • Dehydrate (increase lithium toxicity), SEROTONIN syndrome
Q12. Lithium (Lithobid) SEs • GI upset (N, diarrhea), tremor, cognitive • Polyuria, polydipsia • Weight gain • HyPOthyroid • HyPERcalcemia • Cardiac abnormality, Edema, blue-grey skin, impotence
Q13. Lithium (Lithobid) toxics • >1.5mEq/L: Ataxia, coarse hand tremor, vomiting, diarrhea, sedation • >2.5mEq/L: CNS depression, arrhythmia, seizure, coma
Q14. Lithium (Lithobid) monitoring • Lithium level • Renal • TSH, F4, electrolytes • Renal clearance • ECG (>40yrs) • Avoid Pregnancy, breasfeeding
Q15. Lithium (Lithobid) DDI: ELEVATE lithum level • NSAIDs (ASA, sulindac: safer) • Reduce salt intake: w ACEi, ARB, Thiazide
Q16. Lithium (Lithobid) DDI: decrease level • Increase salt intake, caffein, theophylline
Q17. Lithium (Lithobid) DDI: SEROTONIN syndrone • SSRI, SNRI, triptan, linezolid
Q18. Lithium (Lithobid) DDI: Neurotoxicity • NonDHP-CCB • Phenytoin, carbamazepine
Q19. Option for pregnancy • Lamotrigine or SGAs • Lurasidone: most favorable • AVOID: Valproate (esp 1st tremeter), Carbamazepine (eps 1st), Lithium
Q20. Lithium covertion btw formulation • 300mg carbonate tab/cap = 8 mEq = 5mL citrate
Q21. Lithium counsel • Food • Consistant salt intake • Hydrate w/o caffein • Avoid: Pregnancy, breastfeeding • HCPs if worsening N/D, slurred speech, confusion • Impair alertness
Q22. Symbyax • Olanzapine/fluoxetine • Bipolar depression
Q23. Lurasidone • Bipolar depression.
Q24. Lamotrigine • Bipolar depression • Maintenance treatment • NOT for acute mania (slow titration) • Severe rash, SJS
Q25. Carbamazepine (Equetro) • Bipolar mania
Q26. Valproate • Bipolar mania
Q27. Aripiprazole brand Abilify, Abilify Maintena
Q28. Olanzapine brand Zyprexa
Q29. Quetiapine brand Seroquel
Q30. Risperidone brand Risperdal
Q31. Ziprasidone brand Geodon
Q32. Asenapine brand Saphris
Q33. Lurasidone brand Latuda
Q34. Cariprazine brand Vraylar
Q35. Lithium and Salt Up - Down: opposite
Created by: dao.vo11017
 

 



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