Georgette Module 1 & 2: Questions With Clear
Solutions
Lithium level Correct Answer - 0.6-1.2
Lithium toxicity level Correct Answer - greater than or equal to 1.5
what is the gold standard for treating manic episodes? Correct Answer -
Lithium
What drug has evidence of anti-suicidal effects for bipolar disorder? Correct
Answer - Lithium
baseline labs to collect in order to R/O medical diagnoses prior to giving
Lithium Correct Answer - 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 Answer - pregnancy test
what is considered child-bearing age? Correct Answer - 12-51
SE of Lithium? (endocrine) Correct Answer - HYPOthyroidism
SE of Lithium? (CNS) Correct Answer - **course hand tremors w/ toxicity
SE of Lithium? (dermatological) Correct Answer - Maculopapular rash
SE of Lithium? (GI) Correct Answer - diarrhea, vomiting, cramp, anorexia
**imp. because these become severe w/ toxicity
SE of Lithium? (Renal) Correct Answer - diabetes insipidus (polyuria r/t
polydipsia)
SE of Lithium? (Cardiac) Correct Answer - T-wave inversions
,SE of Lithium? (Hematologic) Correct Answer - leukocytosis (increased
WBC)
Hypertensive Crisis occurs when..... Correct Answer - MAOIs are taken in
conjunction w/ foods containing TYRAMINE (dietary precursor of NE)
Hypertensive crisis is _____-__________ and cannot be reversed unless.....
Correct Answer - life-threatening & cannot be reversed unless more MAO is
produced by the body
Hypertensive crisis & death can occur when MAOIs are taken in conjunction
with which types of meds?? Correct Answer - ***Meperidine
***Stimulants/other sympathomimetics
Decongestants/TCA/SGA/St. Johns Wort/L-tryptophan
Symptoms of Hypertensive crisis include Correct Answer - sudden
explosive-like HA in OCCIPITAL region
Fever**
Treatment of Hypertensive Crisis Correct Answer - 1. d/c offending agent
(MAOI)
2. administer PHENTOLAMINE
3. Stabilize fever
medication to reverse hypertensive crisis w/ MAOI? Correct Answer -
Phentolamine****
List of common MAOIs (don't need to memorize, just know what it looks like)
Correct Answer - Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (Emsam)
Tranylcypromine (Parnate)
Teratogenic risks of common psych meds (Benzo, Carbamazepine, Lithium,
Depakote) Correct Answer - 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 Answer - Steven Johnson's Syndrome*** (SE
below, KNOW)
- Fever**
- Sore throat (may feel like burning**
- Facial/tongue swelling**
- Skin sloughing***
- Prodromal HA, malaise, Arthralgia, painful mucous membranes may occur
BEFORE rash
Valproic Acid/Divalproex Sodium aka Depakote main SE Correct Answer -
Hepatotoxicity**
Pancreatitis**
Carbamazepine (Tegretol) main SE Correct Answer - Agranulocytosis***
Aplastic Anemia***
Steven-Johnson's*** (mainly Asians HLAB-1502 allele)
Aplastic Anemia s/s Correct Answer - pallor, fatigue, HA, fever, nose
bleeds, bleeding gums, skin rash, SOB
Carbamazepine when to d/c Correct Answer - 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 Answer - HLA-B
1502 allele in Asians d/t Steven's Johnson Syndrome
Clozapine main SE Correct Answer - Risk for NEUTROPENIA --> monitor
for s/s of infection***
Neutropenia is monitored only by... Correct Answer - ANC
when to d/c Clozapine? Correct Answer - ANC <1000
WBC 2000-3000
Check ____ before starting female of childbearing age (12-51yr) on
psychotropic med Correct Answer - HCG
, Folic acid does what & what is the recommended dosage? Correct Answer -
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 Answer - Fever
Sore throat (burning feeling)
Facial/Tongue Swelling
Rash
Skin Sloughing
Symptoms of Steven's Johnson Syndrome PRIOR to it occuring Correct
Answer - Prodromal HA
Malaise
Arthralgia (joint stiffness)
Painful mucous membranes
What two mood stabilizers can cause Steven's Johnson Syndrome? Correct
Answer - Lamictal (in everyone) & Carbamazepine (in Asians)
What two medications are at risk for causing agranulocytosis (decreased
WBC)? Correct Answer - Carbamazepine & Clozapine
Recommended Folic acid dosage for those of child-bearing age Correct
Answer - 0.4-0.8mg/day
BMI ranges Correct Answer - underweight: <18.5
normal: 18.5-24.9
overweight: 25-29.9
obese: >30
Bulimia Nervosa BMI Correct Answer - is normal 18.5-24.9
Bulimia Nervosa signs/syptoms Correct Answer - Normal BMI
Erosion of dental enamel d/t induced vomiting
Russell's sign (calluses to back of hand)
Hypertrophy of salivary glands (vomiting)
Solutions
Lithium level Correct Answer - 0.6-1.2
Lithium toxicity level Correct Answer - greater than or equal to 1.5
what is the gold standard for treating manic episodes? Correct Answer -
Lithium
What drug has evidence of anti-suicidal effects for bipolar disorder? Correct
Answer - Lithium
baseline labs to collect in order to R/O medical diagnoses prior to giving
Lithium Correct Answer - 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 Answer - pregnancy test
what is considered child-bearing age? Correct Answer - 12-51
SE of Lithium? (endocrine) Correct Answer - HYPOthyroidism
SE of Lithium? (CNS) Correct Answer - **course hand tremors w/ toxicity
SE of Lithium? (dermatological) Correct Answer - Maculopapular rash
SE of Lithium? (GI) Correct Answer - diarrhea, vomiting, cramp, anorexia
**imp. because these become severe w/ toxicity
SE of Lithium? (Renal) Correct Answer - diabetes insipidus (polyuria r/t
polydipsia)
SE of Lithium? (Cardiac) Correct Answer - T-wave inversions
,SE of Lithium? (Hematologic) Correct Answer - leukocytosis (increased
WBC)
Hypertensive Crisis occurs when..... Correct Answer - MAOIs are taken in
conjunction w/ foods containing TYRAMINE (dietary precursor of NE)
Hypertensive crisis is _____-__________ and cannot be reversed unless.....
Correct Answer - life-threatening & cannot be reversed unless more MAO is
produced by the body
Hypertensive crisis & death can occur when MAOIs are taken in conjunction
with which types of meds?? Correct Answer - ***Meperidine
***Stimulants/other sympathomimetics
Decongestants/TCA/SGA/St. Johns Wort/L-tryptophan
Symptoms of Hypertensive crisis include Correct Answer - sudden
explosive-like HA in OCCIPITAL region
Fever**
Treatment of Hypertensive Crisis Correct Answer - 1. d/c offending agent
(MAOI)
2. administer PHENTOLAMINE
3. Stabilize fever
medication to reverse hypertensive crisis w/ MAOI? Correct Answer -
Phentolamine****
List of common MAOIs (don't need to memorize, just know what it looks like)
Correct Answer - Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (Emsam)
Tranylcypromine (Parnate)
Teratogenic risks of common psych meds (Benzo, Carbamazepine, Lithium,
Depakote) Correct Answer - 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 Answer - Steven Johnson's Syndrome*** (SE
below, KNOW)
- Fever**
- Sore throat (may feel like burning**
- Facial/tongue swelling**
- Skin sloughing***
- Prodromal HA, malaise, Arthralgia, painful mucous membranes may occur
BEFORE rash
Valproic Acid/Divalproex Sodium aka Depakote main SE Correct Answer -
Hepatotoxicity**
Pancreatitis**
Carbamazepine (Tegretol) main SE Correct Answer - Agranulocytosis***
Aplastic Anemia***
Steven-Johnson's*** (mainly Asians HLAB-1502 allele)
Aplastic Anemia s/s Correct Answer - pallor, fatigue, HA, fever, nose
bleeds, bleeding gums, skin rash, SOB
Carbamazepine when to d/c Correct Answer - 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 Answer - HLA-B
1502 allele in Asians d/t Steven's Johnson Syndrome
Clozapine main SE Correct Answer - Risk for NEUTROPENIA --> monitor
for s/s of infection***
Neutropenia is monitored only by... Correct Answer - ANC
when to d/c Clozapine? Correct Answer - ANC <1000
WBC 2000-3000
Check ____ before starting female of childbearing age (12-51yr) on
psychotropic med Correct Answer - HCG
, Folic acid does what & what is the recommended dosage? Correct Answer -
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 Answer - Fever
Sore throat (burning feeling)
Facial/Tongue Swelling
Rash
Skin Sloughing
Symptoms of Steven's Johnson Syndrome PRIOR to it occuring Correct
Answer - Prodromal HA
Malaise
Arthralgia (joint stiffness)
Painful mucous membranes
What two mood stabilizers can cause Steven's Johnson Syndrome? Correct
Answer - Lamictal (in everyone) & Carbamazepine (in Asians)
What two medications are at risk for causing agranulocytosis (decreased
WBC)? Correct Answer - Carbamazepine & Clozapine
Recommended Folic acid dosage for those of child-bearing age Correct
Answer - 0.4-0.8mg/day
BMI ranges Correct Answer - underweight: <18.5
normal: 18.5-24.9
overweight: 25-29.9
obese: >30
Bulimia Nervosa BMI Correct Answer - is normal 18.5-24.9
Bulimia Nervosa signs/syptoms Correct Answer - Normal BMI
Erosion of dental enamel d/t induced vomiting
Russell's sign (calluses to back of hand)
Hypertrophy of salivary glands (vomiting)
