MH701 Exam 2: Mood Stabilizers and Antipsychotics Exam Questions And Answers Verified 100% Correct

MH701 Exam 2: Mood Stabilizers and Antipsychotics Exam Questions And Answers Verified 100% Correct Lamotrigine can also be used for ___ - ANSWER Bipolar depression Bipolar mania (adjunct, second-line) MDD (adjunct) Neuropathic or chronic pain Lamotrigine half-life - ANSWER 25 hrs Why does lamotrigine need to be titrated slowly? - ANSWER To reduce risk of rash & SJS Lamotrigine MOA - ANSWER Modestly increases serum serotonin concentrations, possibly through inhibition of reuptake (antidepressive effect) Lamotrigine side effects - ANSWER Dizziness, ataxia, somnolence, HA, blurred vision Nausea Rash (common): could manifest to *SJS* Out of all the mood stabilizers/anticonvulsants, lamotrigine is least like to cause __ and __ - ANSWER Weight gain and sedation Lamotrigine D2D - ANSWER Valproate (will cause increased lamotrigine concentrations) Carbamazepine is FDA approved for ___ - ANSWER Acute mania Mixed mania Carbamazepine can also be used for ___ - ANSWER Bipolar depression Bipolar maintenance Schizo (adjunct) Carbamazepine... Peak concentrations Steady state Half-life - ANSWER Peak concentrations: 2-8 hrs after single dose Steady state: 2-4 days on steady dose Half-life: 18-54 hrs (26 avg) TERM ENGLISH Carbamazepine is metabolized by ___ - ANSWER liver Carbamazepine MOA - ANSWER inhibiting voltage-gated sodium channels, augmenting GABA transmission Upon initiation, when should you recheck carbamazepine trough levels? (inpatient v. outpatient) - ANSWER Inpatient: 3 days Outpatient: 1 week Baseline lab monitoring prior to initiation of carbamazepine - ANSWER CBC, liver, kidney, TSH Carbamazepine side effects (hint: they ain't good) - ANSWER Neuro: Vertigo, double/blurred vision GI disturbances *Liver failure* Hematologic: *agranulocytosis*, aplastic anemia Skin: rash, *SJS* Pancreatitis *Teratogen* Higher risk for SJS when taking carbamazepine in what population? - ANSWER Asians. Genetic screening of HLA-B*1502 gene recommended. Carbamazepine D2D - ANSWER MAOI (stop taking 2 weeks before) Oral contraceptives (decreases effectiveness) Valproate (carb dose will increase, valproate will decrease) Oxycarbamazapine indications - ANSWER Aggression, impulsivity (lack of proven efficacy) Oxycarbamazapine most common side effects - ANSWER Sedation, nausea, hyponatremia (even though structurally r/t carbamazepine, does not have hematologic side effects) Labs to check with oxycarbamazapine - ANSWER BMP (for hyponatremia) Is gabapentin FDA approved for BPD? - ANSWER No... and not for any psych disorders. Recently changed to schedule IV drug ___ will reduce bioavailability of gabapentin by as much as 20% - ANSWER Antacids Topiramate is useful for ___ - ANSWER impulsivity and weight loss Noteworthy risk of topiramate.... - ANSWER May increase suicidal thoughts If a patient has suicidal ideation, what drug is recommended? - ANSWER Lithium Neurotransmitters involved in schizophrenia - ANSWER Dopamine ↑ Serotonin ↑ GABA ↓ Neuropathology of schizophrenia - ANSWER Reduced volumes of gray matter and enlarged cerebral ventricles Reduced symmetry and reduced limbic system Anatomical abnormality of PFC Which dopamine pathway may be involved in the positive symptoms of schizophrenia? - ANSWER Hyperactivity of the mesolimbic pathway Which dopamine pathway may be involved in the negative symptoms of schizophrenia? - ANSWER Deficit of dopamine in mesocortical pathway Dopamine's role in the ____ pathway affects involuntary movement - ANSWER nigrostriatal What are the differences among 1st gen and 2nd gen antipsychotics? - ANSWER 1st gen: Greater affinity for dopamine receptor No effect on serotonin Neuro & motor side effects 2nd gen: Less affinity for dopamine receptor Increases serotonin