GEORGETTE MODULE 1 -2
QUESTIONS WITH COMPLETE
SOLUTIONS 2025
Lithium toxicity can occur when this level reaches ?. - ANSWER1.5 mEq or higher
Gold standard for treatment of manic episodes. - Evidence of anti-suicidal effects. -
ANSWERLithium
- Neuroprotective treatment of choice for bipolar disorder (protects nerve cells from
damage) - ANSWERLithium
baseline labs to get prior to starting lithium: - ANSWERTSH, creatinine (0.6-1.2), BUN
(10-20), pregnancy test (HCG), EKG (if older than 50 years old)
- Hypothyroidism
- weight gain
- fine hand tremor
- fatigue
- mental cloudiness
- headaches
- nystagmus
- acne
- maculopapular rash
- pruritus
- GI upset
- Diarrhea
- vomiting
- cramps
- anorexia
- renal issues
- edema
- diabetes insipidus
- polyuria
- polydipsia
- microscopic tubular changes
- cardiac issues (T wave inversion, dysrhythmias)
- hematological issues (Leukocytosis) - ANSWERLithium side effect
Examples of things that can decrease renal clearance, by possibly increasing
concentration of drugs that are excreted by kidneys (for example lithium -
,ANSWERKidney disease or drugs (such as NSAIDs (ibuprofen, Indocin), thiazides
(HCTZ), ACE inhibitors (lisinopril),)
Signs and symptoms of lithium toxicity: - ANSWER- Severe nausea, vomiting, and
diarrhea
- Confusion
- Convulsions
- Drowsiness
- blurred vision
- slurred speech
- muscle weakness
- heart palpitations
- coarse hand tremors
- ataxia (unsteadiness while standing or walking)
Interventions for lithium toxicity - ANSWERstop lithium and check serum lithium levels
can occur when MAOI (isocarboxazides, phenelzine, selegeline, tranylcypromine) are
taken in conjunction with foods containing tyramine a dietary precursor to
norepinephrine. - ANSWERHypertensive crisis
- life threatening and cannot be reversed unless more MAO Is produced by the body -
ANSWERHypertensive crisis
- Hypertensive crisis and death can occur when MAOIs are taken in conjunction with
certain meds - ANSWERo meperidine
o Stimulants
o Decongestants
o tricyclic antidepressants
o atypical antipsychotics
o St. John's wort
o asthma medications
Signs and symptoms of hypertensive crisis - ANSWER- elevated blood pressure
(Greater than or = to 180/120)
- sudden explosive like headache (Occipital region usually)
- facial flushing
- palpitations
- Fever
- pupillary dilation
- diaphoresis
Treatment for hypertensive crisis: - ANSWER- stop the MAOI
- give phentolamine
- stabilize fever
- review diet in Med guidelines with patient
, Teratogenic risk Benzodiazepine - ANSWERfloppy baby syndrome, cleft palate
Teratogenic risk Carbamazepine (Tegretol) - ANSWERneural tube defects
Teratogenic risk Lithium - ANSWER- Epstein anomaly
Teratogenic risk divalproex sodium (Depakote) - ANSWER- neural tube defects,
*specifically spina bifida, atrial septal defect, cleft palate, impossible long term
developmental deficits
Lamictal black box warning for - ANSWERStevens Johnson syndrome
- signs and symptoms of Steven Johnson syndrome - ANSWERo Fever
o sore throat
o tongue swelling
o facial swelling
o rash
o skin sloughing
o Prodromal headache
o Malaise
o Arthralgia (joint stiffness)
o painful mucous membranes may occur before rash
Depakote- BB warning: - ANSWERHepatotoxicity, pancreatitis
Carbamazepine (Tegretol) Black box warning for - ANSWERagranulocytosis and a
plastic anemia (pallor, fatigue, headache, fever, nosebleeds, bleeding gums, skin rash,
shortness of breath)
This medication can cause Steven Johnson syndrome particularly in Asian patients and
you should screen for HLA-B 1502 allele before initiating - ANSWERCarbamazepine
(Tegretol)
- it is recommended that all women planning or capable of becoming pregnant take
0.4mg - 0.8mg folic acid daily to prevent - ANSWERneural tube defects
Meds with the risk of decreasing neutrophil count - ANSWERClozaril and
carbamazepine
monitored by ANC only, not in conjunction with WBC - ANSWERClozaril and
carbamazepine
Normal ANC - ANSWER2500-6000
Normal range WBC - ANSWER4500-11,000
QUESTIONS WITH COMPLETE
SOLUTIONS 2025
Lithium toxicity can occur when this level reaches ?. - ANSWER1.5 mEq or higher
Gold standard for treatment of manic episodes. - Evidence of anti-suicidal effects. -
ANSWERLithium
- Neuroprotective treatment of choice for bipolar disorder (protects nerve cells from
damage) - ANSWERLithium
baseline labs to get prior to starting lithium: - ANSWERTSH, creatinine (0.6-1.2), BUN
(10-20), pregnancy test (HCG), EKG (if older than 50 years old)
- Hypothyroidism
- weight gain
- fine hand tremor
- fatigue
- mental cloudiness
- headaches
- nystagmus
- acne
- maculopapular rash
- pruritus
- GI upset
- Diarrhea
- vomiting
- cramps
- anorexia
- renal issues
- edema
- diabetes insipidus
- polyuria
- polydipsia
- microscopic tubular changes
- cardiac issues (T wave inversion, dysrhythmias)
- hematological issues (Leukocytosis) - ANSWERLithium side effect
Examples of things that can decrease renal clearance, by possibly increasing
concentration of drugs that are excreted by kidneys (for example lithium -
,ANSWERKidney disease or drugs (such as NSAIDs (ibuprofen, Indocin), thiazides
(HCTZ), ACE inhibitors (lisinopril),)
Signs and symptoms of lithium toxicity: - ANSWER- Severe nausea, vomiting, and
diarrhea
- Confusion
- Convulsions
- Drowsiness
- blurred vision
- slurred speech
- muscle weakness
- heart palpitations
- coarse hand tremors
- ataxia (unsteadiness while standing or walking)
Interventions for lithium toxicity - ANSWERstop lithium and check serum lithium levels
can occur when MAOI (isocarboxazides, phenelzine, selegeline, tranylcypromine) are
taken in conjunction with foods containing tyramine a dietary precursor to
norepinephrine. - ANSWERHypertensive crisis
- life threatening and cannot be reversed unless more MAO Is produced by the body -
ANSWERHypertensive crisis
- Hypertensive crisis and death can occur when MAOIs are taken in conjunction with
certain meds - ANSWERo meperidine
o Stimulants
o Decongestants
o tricyclic antidepressants
o atypical antipsychotics
o St. John's wort
o asthma medications
Signs and symptoms of hypertensive crisis - ANSWER- elevated blood pressure
(Greater than or = to 180/120)
- sudden explosive like headache (Occipital region usually)
- facial flushing
- palpitations
- Fever
- pupillary dilation
- diaphoresis
Treatment for hypertensive crisis: - ANSWER- stop the MAOI
- give phentolamine
- stabilize fever
- review diet in Med guidelines with patient
, Teratogenic risk Benzodiazepine - ANSWERfloppy baby syndrome, cleft palate
Teratogenic risk Carbamazepine (Tegretol) - ANSWERneural tube defects
Teratogenic risk Lithium - ANSWER- Epstein anomaly
Teratogenic risk divalproex sodium (Depakote) - ANSWER- neural tube defects,
*specifically spina bifida, atrial septal defect, cleft palate, impossible long term
developmental deficits
Lamictal black box warning for - ANSWERStevens Johnson syndrome
- signs and symptoms of Steven Johnson syndrome - ANSWERo Fever
o sore throat
o tongue swelling
o facial swelling
o rash
o skin sloughing
o Prodromal headache
o Malaise
o Arthralgia (joint stiffness)
o painful mucous membranes may occur before rash
Depakote- BB warning: - ANSWERHepatotoxicity, pancreatitis
Carbamazepine (Tegretol) Black box warning for - ANSWERagranulocytosis and a
plastic anemia (pallor, fatigue, headache, fever, nosebleeds, bleeding gums, skin rash,
shortness of breath)
This medication can cause Steven Johnson syndrome particularly in Asian patients and
you should screen for HLA-B 1502 allele before initiating - ANSWERCarbamazepine
(Tegretol)
- it is recommended that all women planning or capable of becoming pregnant take
0.4mg - 0.8mg folic acid daily to prevent - ANSWERneural tube defects
Meds with the risk of decreasing neutrophil count - ANSWERClozaril and
carbamazepine
monitored by ANC only, not in conjunction with WBC - ANSWERClozaril and
carbamazepine
Normal ANC - ANSWER2500-6000
Normal range WBC - ANSWER4500-11,000
