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