Georgette Module 1 & 2
Lithium level Correct answers
0.6-1.2
Lithium toxicity level Correct answers greater than or
equal to 1.5
what is the gold standard for treating manic episodes? Correct
answers Lithium
What drug has evidence of anti-suicidal effects for bipolar disorder?
Correct answers
Lithiu
m
baseline labs to collect in order to R/O medical diagnoses prior to giving
Lithium Correct
answers TSH (r/o
bipolar)
Creatinine (0.6-
1.2)
BUN (10-
20)
Pregnancy
test
ECG if greater than 50 (inverted T-
waves)
All psychotropics should have what test prior to giving for child-bearing
age? Correct
answers pregnancy
test
what is considered child-bearing age? Correct
answers 12-51
SE of Lithium? (endocrine) Correct answers
HYPOthyroidism
SE of Lithium? (CNS) Correct answers **course hand tremors w/
toxicity
SE of Lithium? (dermatological) Correct answers
Maculopapular rash
SE of Lithium? (GI) Correct answers diarrhea, vomiting, cramp,
anorexia
**imp. because these become severe w/
toxicity
SE of Lithium? (Renal) Correct answers diabetes insipidus (polyuria r/t
polydipsia)
SE of Lithium? (Cardiac) Correct answers T-wave
inversions
SE of Lithium? (Hematologic) Correct answers leukocytosis
(increased WBC)
Hypertensive Crisis occurs when..... Correct answers MAOIs are taken in
conjunction
foods w/ TYRAMINE (dietary precursor
containing
of NE)
,Hypertensive crisis is - and cannot be reversed unless.....
answers life-threatening & cannot be reversed unless more MAO is
Correct
produced by the
bod
y
Hypertensive crisis & death can occur when MAOIs are taken in conjunction
with which
types of meds?? Correct answers
***Meperidine
***Stimulants/other
sympathomimetics
Decongestants/TCA/SGA/St. Johns Wort/L-
tryptophan
Symptoms of Hypertensive crisis include Correct answers sudden explosive-
like HA in
OCCIPITAL
region
Fever*
*
Treatment of Hypertensive Crisis Correct answers 1. d/c offending
agent
2. (MAOI)
administer
PHENTOLAMINE
3. Stabilize
fever
medication to reverse hypertensive crisis w/ MAOI? Correct answers
Phentolamine****
List of common MAOIs (don't need to memorize, just know what it looks
like) Correct
answers Isocarboxazid
(Marplan)
Phenelzine
(Nardil)
Selegiline
(Emsam)
Tranylcypromine
(Parnate)
Teratogenic risks of common psych meds (Benzo, Carbamazepine, Lithium,
Depakote)
Correct answers Benzo: floppy baby & cleft
palate
Carbamazepine: neural tube
defect
Lithium: Epstein's anomaly & Congenital heart defects (esp. 1st
trimester)
Depakote: Neural tube defects (spec. spina
bifida)
Lamicatal main SE Correct answers Steven Johnson's Syndrome*** (SE
-below, KNOW)
Fever**
- Sore throat (may feel like
burning**
- Facial/tongue
swelling**
- Skin
- Prodromal HA, malaise, Arthralgia, painful mucous membranes may occur
sloughing***
BEFORE
ras
h
Valproic Acid/Divalproex Sodium aka Depakote main SE Correct
answers
Hepatotoxicity
**
Pancreatitis
**
Carbamazepine (Tegretol) main SE Correct answers
Agranulocytosis***
Aplastic
Anemia***
Steven-Johnson's*** (mainly Asians HLAB-1502
allele)
, Aplastic Anemia s/s Correct answers pallor, fatigue, HA, fever, nose
bleeds,skin
gums, bleeding
rash,
SOB
Carbamazepine when to d/c Correct answers WBC
2000-3000
ANC <
1000
Rash/Steven
Johnson's
Or s/s of aplastic anemia or
agranulocytosis
What to test prior to prescribing Cabamazepine?? Correct answers HLA-B
1502 allele
Asians in
d/t Steven's Johnson
Syndrome
Clozapine main SE Correct answers Risk for NEUTROPENIA --> monitor
for s/s of
infection*
**
Neutropenia is monitored only by... Correct
answers ANC
when to d/c Clozapine? Correct answers ANC
<1000
WBC 2000-
3000
Check before starting female of childbearing age (12-51yr) on
Correct answers
psychotropic med
HCG
Folic acid does what & what is the recommended dosage? Correct answers
supports neural tube development during FIRST month of pregnancy-->
ALWAYS encourage those of childbearing age to take (OTC medication)
Dosage= 0.4-0.8mg daily for all women planning or capable of becoming
pregnant**
Symptoms of Steven's Johnson Syndrome Correct
answers
Sore Fever
throat (burning
Facial/Tongue
feeling)
Swelling
Rash
Skin
Sloughing
Symptoms of Steven's Johnson Syndrome PRIOR to it occuring Correct
answers
Prodromal
Malais
HA
e
Arthralgia (joint
stiffness)
Painful mucous
membranes
What two mood stabilizers can cause Steven's Johnson Syndrome? Correct
answers
Lamictal (in everyone) & Carbamazepine (in
Asians)
What two medications are at risk for causing agranulocytosis
(decreased
Correct WBC)?
answers Carbamazepine &
Clozapine
Lithium level Correct answers
0.6-1.2
Lithium toxicity level Correct answers greater than or
equal to 1.5
what is the gold standard for treating manic episodes? Correct
answers Lithium
What drug has evidence of anti-suicidal effects for bipolar disorder?
Correct answers
Lithiu
m
baseline labs to collect in order to R/O medical diagnoses prior to giving
Lithium Correct
answers TSH (r/o
bipolar)
Creatinine (0.6-
1.2)
BUN (10-
20)
Pregnancy
test
ECG if greater than 50 (inverted T-
waves)
All psychotropics should have what test prior to giving for child-bearing
age? Correct
answers pregnancy
test
what is considered child-bearing age? Correct
answers 12-51
SE of Lithium? (endocrine) Correct answers
HYPOthyroidism
SE of Lithium? (CNS) Correct answers **course hand tremors w/
toxicity
SE of Lithium? (dermatological) Correct answers
Maculopapular rash
SE of Lithium? (GI) Correct answers diarrhea, vomiting, cramp,
anorexia
**imp. because these become severe w/
toxicity
SE of Lithium? (Renal) Correct answers diabetes insipidus (polyuria r/t
polydipsia)
SE of Lithium? (Cardiac) Correct answers T-wave
inversions
SE of Lithium? (Hematologic) Correct answers leukocytosis
(increased WBC)
Hypertensive Crisis occurs when..... Correct answers MAOIs are taken in
conjunction
foods w/ TYRAMINE (dietary precursor
containing
of NE)
,Hypertensive crisis is - and cannot be reversed unless.....
answers life-threatening & cannot be reversed unless more MAO is
Correct
produced by the
bod
y
Hypertensive crisis & death can occur when MAOIs are taken in conjunction
with which
types of meds?? Correct answers
***Meperidine
***Stimulants/other
sympathomimetics
Decongestants/TCA/SGA/St. Johns Wort/L-
tryptophan
Symptoms of Hypertensive crisis include Correct answers sudden explosive-
like HA in
OCCIPITAL
region
Fever*
*
Treatment of Hypertensive Crisis Correct answers 1. d/c offending
agent
2. (MAOI)
administer
PHENTOLAMINE
3. Stabilize
fever
medication to reverse hypertensive crisis w/ MAOI? Correct answers
Phentolamine****
List of common MAOIs (don't need to memorize, just know what it looks
like) Correct
answers Isocarboxazid
(Marplan)
Phenelzine
(Nardil)
Selegiline
(Emsam)
Tranylcypromine
(Parnate)
Teratogenic risks of common psych meds (Benzo, Carbamazepine, Lithium,
Depakote)
Correct answers Benzo: floppy baby & cleft
palate
Carbamazepine: neural tube
defect
Lithium: Epstein's anomaly & Congenital heart defects (esp. 1st
trimester)
Depakote: Neural tube defects (spec. spina
bifida)
Lamicatal main SE Correct answers Steven Johnson's Syndrome*** (SE
-below, KNOW)
Fever**
- Sore throat (may feel like
burning**
- Facial/tongue
swelling**
- Skin
- Prodromal HA, malaise, Arthralgia, painful mucous membranes may occur
sloughing***
BEFORE
ras
h
Valproic Acid/Divalproex Sodium aka Depakote main SE Correct
answers
Hepatotoxicity
**
Pancreatitis
**
Carbamazepine (Tegretol) main SE Correct answers
Agranulocytosis***
Aplastic
Anemia***
Steven-Johnson's*** (mainly Asians HLAB-1502
allele)
, Aplastic Anemia s/s Correct answers pallor, fatigue, HA, fever, nose
bleeds,skin
gums, bleeding
rash,
SOB
Carbamazepine when to d/c Correct answers WBC
2000-3000
ANC <
1000
Rash/Steven
Johnson's
Or s/s of aplastic anemia or
agranulocytosis
What to test prior to prescribing Cabamazepine?? Correct answers HLA-B
1502 allele
Asians in
d/t Steven's Johnson
Syndrome
Clozapine main SE Correct answers Risk for NEUTROPENIA --> monitor
for s/s of
infection*
**
Neutropenia is monitored only by... Correct
answers ANC
when to d/c Clozapine? Correct answers ANC
<1000
WBC 2000-
3000
Check before starting female of childbearing age (12-51yr) on
Correct answers
psychotropic med
HCG
Folic acid does what & what is the recommended dosage? Correct answers
supports neural tube development during FIRST month of pregnancy-->
ALWAYS encourage those of childbearing age to take (OTC medication)
Dosage= 0.4-0.8mg daily for all women planning or capable of becoming
pregnant**
Symptoms of Steven's Johnson Syndrome Correct
answers
Sore Fever
throat (burning
Facial/Tongue
feeling)
Swelling
Rash
Skin
Sloughing
Symptoms of Steven's Johnson Syndrome PRIOR to it occuring Correct
answers
Prodromal
Malais
HA
e
Arthralgia (joint
stiffness)
Painful mucous
membranes
What two mood stabilizers can cause Steven's Johnson Syndrome? Correct
answers
Lamictal (in everyone) & Carbamazepine (in
Asians)
What two medications are at risk for causing agranulocytosis
(decreased
Correct WBC)?
answers Carbamazepine &
Clozapine
