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Exam 1
Pharmacology
| Antimanic Drugs | antimanc Drugs Answer | Stimulant | Stimulant Answer | Elderly & Psychotropic Drugs | Elderly Answers |
|---|---|---|---|---|---|
| Mechanism of action of Lithium in treating mania? | Lithium decreases biogenic activity in 3 ways: 1) enhances reuptake of NE and serotonin into presynaptic membranes. 2) reduces release of NE from presyn. vesicles by competing w/ Ca 3) reduces NE postsynaptic action | ||||
| ID drugs used during initial treatment of mania and give rationale | MANIC PHASE Initial: Lithium + Antipsychotic Clorpromazine (Thorazine) or another antipsych. drug at a high dose, makes severe manic behavior manageable until lithium takes effect. *Haldol & Mellaril should not be given w/ Lithium - EPS's | ||||
| Rationale for taking regular serum lithium levels | Lithiums therapeutic index is very low. We check serum levels for toxicity. 0.6-1.5 mEq/L is therapeutic. | ||||
| how long after taking lithium dose should blood be drawn to determine serum lithium level and why? | Lithium has a biphasic elimination pattern. 1st phase = 1st 5 hours & fast elimination. 2nd phase = next 18 hours and elimination slows. Take blood draw during 2nd phase, @ 1st phase person will seem toxic. | ||||
| What is the therapeutic range for serum lithium level? | 0.6-1.5 mEq/L, >2.0 mEq/L = toxicity | ||||
| What is the length of time for a therapeutic effect? | 1-3 weeks | ||||
| How can Bipolar disorder be treated with drugs? | A combo of lithium to control manic phases & an antidepressant to control depressive phases. | ||||
| What is a prophylactic therapy for cluster headaches? | Lithium + antidepressant | ||||
| How do Na & H20 affect Lithium use? | While taking lithium it is important to maintain normal levels of Na & H2O. Depletion causes lithium toxicity and excessive amounts lead to a decrease in lithium therapeutic levels. | ||||
| Symptoms of mild lithium toxicity? | may occur when lithium levels are < 1.5 mEq/L: Fine hand tremor (50%) and muscle weakness (30%) | ||||
| Symptoms of moderate lithium toxicity? | may occur when lithium levels are 1.5-2.0 mEq/L: coarse tremor, twitching, increased muscle tone, ataxia, verigo, confusion, lethargy, sedation, slurred speech, tinnitus, blurred vision, giddiness. GI effects include - nausea, vomiting, diarrhea, anorexia | ||||
| Symptoms of severe side lithium toxicity? | may occur when lithium levels are > 2.0 mEq/L: Oliguria, anuria, nystagmus, dysarthria, hallucinations, confusion, hyperflexia, stupor, seizures, coma | ||||
| Conditions contraindicating lithium treatment | Renal failure, cardiac disorders, leukemia, psoriasis, acne, kids < 12 y.o., pregnancy, myesthenia gravis, Parkinson's disease, tardive dyskinesia, cerebellar disorders, seizure disorders, acute neurological disorders, dementia, senile cataracts | ||||
| ID drugs used to treat mania when lithium is not effective | Anticonvulsant drugs - Carbamazepine (Tegretol) & Valproic Acid (Depakene, Depakote) | ||||
| What antipsychotic drug has been approved for use of Bipolar I? | Abilify | ||||
| (blank) | (blank) | Mechanism of action of stimulant drugs in treating mental illness | Promotes the release of biogenic amines from neurons in CNS & PNS. | ||
| (blank) | (blank) | ID meds used to treat ADD | Atomoxetine (Strattera) is 1st line of treatment for ADD/ADHD. It's a non-stimulant - NE reuptake inhibitor. Previously Ritalin was #1 choice - it's a stimulant | ||
| (blank) | (blank) | What are drawbacks to Ritalin use? | Over long period of time growth suppression can occur that may inhibit brain development. Development of depression later in life is also a concern. | ||
| (blank) | (blank) | What are side effects of Strattera? | Increase BP, weight loss, suicide (rare but serious) | ||
| (blank) | (blank) | What is the abuse potential of stimulants? | Amphetamines and methylphenidates have an abuse potential due to euphoric effect. | ||
| (blank) | (blank) | (blank) | (blank) | Side effects of psychotropic meds that elderly are more susceptible to are? | Sedation and orthostatic hypotension can lead to falls. |
| (blank) | (blank) | (blank) | (blank) | Appropriate dosage of psychotropic meds for elderly and why? | 30-50% of regular adult dosage. They're livers and kidneys don't function as well. |
| What is fish oil effective in treating? how? side effects? | Effective in treating Bipolar disorder, manic phase (10g daily). Fish oil is composed of omega-3 fatty acids that decrease cell firing. Side effects include nausea, belching, fish taste, loose stools. Avoide omega -6's: veggie oils, margarine, mayo | (blank) | (blank) | (blank) | (blank) |
| What is St. John's Wort effective in treating? How? | Top 3" of plant are effective in treating mild depression by blocking serotonin reuptake. | (blank) | (blank) | (blank) | (blank) |
Created by:
hfill
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