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