NURS752: Mood Stabalizers questions with \| \| \| \| \|
answers
What is an elevated mood - CORRECT ANSWERS ✔✔3 symptoms
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(elation) or 4 symptoms (irritability):Decreased need for sleep
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Distractibility Excessive involvement in high risk pleasurable \| \| \| \| \| \| \|
activity Flight of ideas Grandiosity Increase in energy, goal-
\| \| \| \| \| \| \| \|
directed activity or psychomotor agitation Pressured speech
\| \| \| \| \| \|
Bipolar spectrum - CORRECT ANSWERS ✔✔There is a huge
\| \| \| \| \| \| \| \| \|
variation in the presentation of patients with bipolar disorder.
\| \| \| \| \| \| \| \| \|
Historically, bipolar disorder has been categorized as I, II, or not
\| \| \| \| \| \| \| \| \| \| \|
otherwise specified (NOS). think of these patients as belonging
\| \| \| \| \| \| \| \| \|
to a bipolar spectrum and to identify subcategories of
\| \| \| \| \| \| \| \| \|
presentations
Bipolar Disorder-Treatment - CORRECT ANSWERS ✔✔Acute
\| \| \| \| \| \|
therapy: manic episode Lithium Valproic acid If needed:
\| \| \| \| \| \| \| \|
antipsychotic or benzo Acute therapy: depressive phase Mood \| \| \| \| \| \| \| \|
stabilizer alone or with an antidepressant Long-term prevention
\| \| \| \| \| \| \| \|
One or more mood stabilizers and other drugs which are needed
\| \| \| \| \| \| \| \| \| \| \|
acutely
Lithium - CORRECT ANSWERS ✔✔MOA: Not clear Lithium is
\| \| \| \| \| \| \| \| \|
effective both for the manic and depressive components. Today
\| \| \| \| \| \| \| \| \|
lithium is preferred for patient with classic (euphoric) mania
\| \| \| \| \| \| \| \| \|
Onset of effect: Antimanic effects begin 5-7 days after onset of
\| \| \| \| \| \| \| \| \| \| \|
treatment. Takes 2-3 weeks to see full lithium effects Renal
\| \| \| \| \| \| \| \| \| \|
excretion of lithium is effected by blood levels of sodium When
\| \| \| \| \| \| \| \| \| \| \|
, Na levels are inadequate it retains Lithium in an attempt to
\| \| \| \| \| \| \| \| \| \| \|
compensate. In the presence of hyponatremia, lithium toxicity \| \| \| \| \| \| \| \|
can occur
\|
Lithium Gold standard A - CORRECT ANSWERS ✔✔1. The exact
\| \| \| \| \| \| \| \| \| \|
mechanism of action for lithium is unknown, but it appears to be
\| \| \| \| \| \| \| \| \| \| \| \|
neuroprotective. 2. Lithium continues to be the gold standard for \| \| \| \| \| \| \| \| \| \|
treating type I bipolar disorder. It is effective for the manic and
\| \| \| \| \| \| \| \| \| \| \| \|
depressive components. Although it is not a particularly good
\| \| \| \| \| \| \| \| \|
antidepressant as monotherapy in unipolar depression, it is \| \| \| \| \| \| \| \|
effective in patients with bipolar disorder. Lithium also has anti-
\| \| \| \| \| \| \| \| \|
suicidal effects when used to treat bipolar disorder.
\| \| \| \| \| \| \|
Lithium Gold Standard B - CORRECT ANSWERS ✔✔3. Antimanic
\| \| \| \| \| \| \| \| \|
effects can occur in 1-2 weeks. Most clinicians use
\| \| \| \| \| \| \| \| \|
antipsychotics or benzodiazepines as adjunctive therapy during \| \| \| \| \| \| \|
this period to cover the agitation and other symptoms.
\| \| \| \| \| \| \| \| \|
Antidepressant effects may take 6-8 weeks. 4. Pharmacokinetics: \| \| \| \| \| \| \| \|
Its half-life is 20-24 hours. It is excreted 95% unchanged by
\| \| \| \| \| \| \| \| \| \| \|
glomerular filtration, and anything that alters the glomerular
\| \| \| \| \| \| \| \|
filtration rate affects its clearance. Pharmacokinetic methods are
\| \| \| \| \| \| \| \|
available for early prediction of doses, but waiting 5-6 days for
\| \| \| \| \| \| \| \| \| \| \|
steady state seems to work just as well.
\| \| \| \| \| \| \|
Lithium Gold standard C - CORRECT ANSWERS ✔✔5. Initial
\| \| \| \| \| \| \| \| \|
dosing is 600-900 mg/day in divided doses and then titrated
\| \| \| \| \| \| \| \| \| \|
according to response and tolerability. Maintenance doses are
\| \| \| \| \| \| \| \|
based on serum concentrations, symptom relief, and the
\| \| \| \| \| \| \| \|
occurrence of adverse effects. 6. A pre-lithium workup includes a
\| \| \| \| \| \| \| \| \| \|
complete blood cell count, electrolytes, renal function, thyroid
\| \| \| \| \| \| \| \|
function tests, urinalysis, ECG, and pregnancy test for women of
\| \| \| \| \| \| \| \| \| \|
childbearing age. \|
answers
What is an elevated mood - CORRECT ANSWERS ✔✔3 symptoms
\| \| \| \| \| \| \| \| \| \|
(elation) or 4 symptoms (irritability):Decreased need for sleep
\| \| \| \| \| \| \| \|
Distractibility Excessive involvement in high risk pleasurable \| \| \| \| \| \| \|
activity Flight of ideas Grandiosity Increase in energy, goal-
\| \| \| \| \| \| \| \|
directed activity or psychomotor agitation Pressured speech
\| \| \| \| \| \|
Bipolar spectrum - CORRECT ANSWERS ✔✔There is a huge
\| \| \| \| \| \| \| \| \|
variation in the presentation of patients with bipolar disorder.
\| \| \| \| \| \| \| \| \|
Historically, bipolar disorder has been categorized as I, II, or not
\| \| \| \| \| \| \| \| \| \| \|
otherwise specified (NOS). think of these patients as belonging
\| \| \| \| \| \| \| \| \|
to a bipolar spectrum and to identify subcategories of
\| \| \| \| \| \| \| \| \|
presentations
Bipolar Disorder-Treatment - CORRECT ANSWERS ✔✔Acute
\| \| \| \| \| \|
therapy: manic episode Lithium Valproic acid If needed:
\| \| \| \| \| \| \| \|
antipsychotic or benzo Acute therapy: depressive phase Mood \| \| \| \| \| \| \| \|
stabilizer alone or with an antidepressant Long-term prevention
\| \| \| \| \| \| \| \|
One or more mood stabilizers and other drugs which are needed
\| \| \| \| \| \| \| \| \| \| \|
acutely
Lithium - CORRECT ANSWERS ✔✔MOA: Not clear Lithium is
\| \| \| \| \| \| \| \| \|
effective both for the manic and depressive components. Today
\| \| \| \| \| \| \| \| \|
lithium is preferred for patient with classic (euphoric) mania
\| \| \| \| \| \| \| \| \|
Onset of effect: Antimanic effects begin 5-7 days after onset of
\| \| \| \| \| \| \| \| \| \| \|
treatment. Takes 2-3 weeks to see full lithium effects Renal
\| \| \| \| \| \| \| \| \| \|
excretion of lithium is effected by blood levels of sodium When
\| \| \| \| \| \| \| \| \| \| \|
, Na levels are inadequate it retains Lithium in an attempt to
\| \| \| \| \| \| \| \| \| \| \|
compensate. In the presence of hyponatremia, lithium toxicity \| \| \| \| \| \| \| \|
can occur
\|
Lithium Gold standard A - CORRECT ANSWERS ✔✔1. The exact
\| \| \| \| \| \| \| \| \| \|
mechanism of action for lithium is unknown, but it appears to be
\| \| \| \| \| \| \| \| \| \| \| \|
neuroprotective. 2. Lithium continues to be the gold standard for \| \| \| \| \| \| \| \| \| \|
treating type I bipolar disorder. It is effective for the manic and
\| \| \| \| \| \| \| \| \| \| \| \|
depressive components. Although it is not a particularly good
\| \| \| \| \| \| \| \| \|
antidepressant as monotherapy in unipolar depression, it is \| \| \| \| \| \| \| \|
effective in patients with bipolar disorder. Lithium also has anti-
\| \| \| \| \| \| \| \| \|
suicidal effects when used to treat bipolar disorder.
\| \| \| \| \| \| \|
Lithium Gold Standard B - CORRECT ANSWERS ✔✔3. Antimanic
\| \| \| \| \| \| \| \| \|
effects can occur in 1-2 weeks. Most clinicians use
\| \| \| \| \| \| \| \| \|
antipsychotics or benzodiazepines as adjunctive therapy during \| \| \| \| \| \| \|
this period to cover the agitation and other symptoms.
\| \| \| \| \| \| \| \| \|
Antidepressant effects may take 6-8 weeks. 4. Pharmacokinetics: \| \| \| \| \| \| \| \|
Its half-life is 20-24 hours. It is excreted 95% unchanged by
\| \| \| \| \| \| \| \| \| \| \|
glomerular filtration, and anything that alters the glomerular
\| \| \| \| \| \| \| \|
filtration rate affects its clearance. Pharmacokinetic methods are
\| \| \| \| \| \| \| \|
available for early prediction of doses, but waiting 5-6 days for
\| \| \| \| \| \| \| \| \| \| \|
steady state seems to work just as well.
\| \| \| \| \| \| \|
Lithium Gold standard C - CORRECT ANSWERS ✔✔5. Initial
\| \| \| \| \| \| \| \| \|
dosing is 600-900 mg/day in divided doses and then titrated
\| \| \| \| \| \| \| \| \| \|
according to response and tolerability. Maintenance doses are
\| \| \| \| \| \| \| \|
based on serum concentrations, symptom relief, and the
\| \| \| \| \| \| \| \|
occurrence of adverse effects. 6. A pre-lithium workup includes a
\| \| \| \| \| \| \| \| \| \|
complete blood cell count, electrolytes, renal function, thyroid
\| \| \| \| \| \| \| \|
function tests, urinalysis, ECG, and pregnancy test for women of
\| \| \| \| \| \| \| \| \| \|
childbearing age. \|
