NURS752 Mood Stabalizers questions with answers

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-
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directed activity or psychomotor agitation Pressured speech
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Bipolar spectrum - CORRECT ANSWERS ✔✔There is a huge
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variation in the presentation of patients with bipolar disorder.
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Historically, bipolar disorder has been categorized as I, II, or not
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otherwise specified (NOS). think of these patients as belonging
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to a bipolar spectrum and to identify subcategories of
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presentations


Bipolar Disorder-Treatment - CORRECT ANSWERS ✔✔Acute
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therapy: manic episode Lithium Valproic acid If needed:
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antipsychotic or benzo Acute therapy: depressive phase Mood \| \| \| \| \| \| \| \|


stabilizer alone or with an antidepressant Long-term prevention
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One or more mood stabilizers and other drugs which are needed
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acutely


Lithium - CORRECT ANSWERS ✔✔MOA: Not clear Lithium is
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effective both for the manic and depressive components. Today
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lithium is preferred for patient with classic (euphoric) mania
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Onset of effect: Antimanic effects begin 5-7 days after onset of
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treatment. Takes 2-3 weeks to see full lithium effects Renal
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excretion of lithium is effected by blood levels of sodium When
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, Na levels are inadequate it retains Lithium in an attempt to
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compensate. In the presence of hyponatremia, lithium toxicity \| \| \| \| \| \| \| \|


can occur
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Lithium Gold standard A - CORRECT ANSWERS ✔✔1. The exact
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mechanism of action for lithium is unknown, but it appears to be
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neuroprotective. 2. Lithium continues to be the gold standard for \| \| \| \| \| \| \| \| \| \|


treating type I bipolar disorder. It is effective for the manic and
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depressive components. Although it is not a particularly good
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antidepressant as monotherapy in unipolar depression, it is \| \| \| \| \| \| \| \|


effective in patients with bipolar disorder. Lithium also has anti-
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suicidal effects when used to treat bipolar disorder.
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Lithium Gold Standard B - CORRECT ANSWERS ✔✔3. Antimanic
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effects can occur in 1-2 weeks. Most clinicians use
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antipsychotics or benzodiazepines as adjunctive therapy during \| \| \| \| \| \| \|


this period to cover the agitation and other symptoms.
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Antidepressant effects may take 6-8 weeks. 4. Pharmacokinetics: \| \| \| \| \| \| \| \|


Its half-life is 20-24 hours. It is excreted 95% unchanged by
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glomerular filtration, and anything that alters the glomerular
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filtration rate affects its clearance. Pharmacokinetic methods are
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available for early prediction of doses, but waiting 5-6 days for
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steady state seems to work just as well.
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Lithium Gold standard C - CORRECT ANSWERS ✔✔5. Initial
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dosing is 600-900 mg/day in divided doses and then titrated
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according to response and tolerability. Maintenance doses are
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based on serum concentrations, symptom relief, and the
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occurrence of adverse effects. 6. A pre-lithium workup includes a
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complete blood cell count, electrolytes, renal function, thyroid
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function tests, urinalysis, ECG, and pregnancy test for women of
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childbearing age. \|