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LUMC Psychiatry

Useful info for LUMC MS3 Psychiatry Clerkship

QuestionAnswer
What mood stabilizer is first-line for bipolar? Lithium
What two drugs are suicide protective? Lithium and Clozaril (Clozapine)
What 4 tests do you need to order for Lithium? 1. Serum Level (0.6-1.2 approps, >1.4 toxic) 2. Thyroid Level (risk hypothyroid) 3. Bun/Cr (Li not metabolized, is renal excretion) 4. ECG (may cause arrythmias)
What patients should not receive Lithium? 1. Pts who are PREGNANT 2. Pts on Diuretics/NSAIDS 3. Pts w/ RENAL PROBLEMS 4. Pts w/ HEART CONDITIONS
What is the treatment of over-dose of lithium? Divalproex sodium, hydration and DIALYSIS - remember renal excretion
What are common side effects of lithium? GI effects, weight GAIN, ACNE, FINE tremor (not course as in OD or toxicity), Thirst (2/2 polyuria), Hair loss Rarer: hypothyroid, arrythmias/CHF, neurotoxicity
Which anticonvulsant is potentially hepatotoxic? 1. Valproic Acid (Depakote) 2. Check LFT’s (& CBC for platelets) 3. Valproic can affect liver & pancreas (hemorrhagic pancreatitis) 4. Valproic may increase risk of PCOS
Which anticonvulsant may cause agranulocytosis? Carbamazepine (Tegretol) - Worried about the blood & heart - Check CBC (&LFT’s—is hepatic inducer) - Chem 7 for rare risk of hyponatremia w/Tegretol
Which anticonvulsant may cause arrhythmias in overdose? Carbamazepine (Tegretol) (OD=stop the heart)
Which anticonvulsants may cause neural tube defects? Valproic Acid (Depakote) & Carbamazepine (Tegretol) Lithium = heart defect, Lamictal = cleft lip/palate
Created by: dsilver2
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