QUESTIONS AND ANSWERS
Lithium level - ANS 0.6-1.2
Lithium toxicity level - ANS greater than or equal to 1.5
what is the gold standard for treating manic episodes? - ANS Lithium
What drug has evidence of anti-suicidal effects for bipolar disorder? - ANS Lithium
baseline labs to collect in order to R/O medical diagnoses prior to giving Lithium - ANS 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? -
ANS pregnancy test
what is considered child-bearing age? - ANS 12-51
1
Page
@COPYRIGHT SIRJOEL 2025/2026
, SE of Lithium? (endocrine) - ANS HYPOthyroidism
SE of Lithium? (CNS) - ANS **course hand tremors w/ toxicity
SE of Lithium? (dermatological) - ANS Maculopapular rash
SE of Lithium? (GI) - ANS diarrhea, vomiting, cramp, anorexia
**imp. because these become severe w/ toxicity
SE of Lithium? (Renal) - ANS diabetes insipidus (polyuria r/t polydipsia)
SE of Lithium? (Cardiac) - ANS T-wave inversions
SE of Lithium? (Hematologic) - ANS leukocytosis (increased WBC)
Hypertensive Crisis occurs when..... - ANS MAOIs are taken in conjunction w/ foods
containing TYRAMINE (dietary precursor of NE)
Hypertensive crisis is _____-__________ and cannot be reversed unless..... - ANS 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?? - ANS ***Meperidine
***Stimulants/other sympathomimetics
Decongestants/TCA/SGA/St. Johns Wort/L-tryptophan
Symptoms of Hypertensive crisis include - ANS sudden explosive-like HA in OCCIPITAL region
2
Page
Fever**
@COPYRIGHT SIRJOEL 2025/2026
, Treatment of Hypertensive Crisis - ANS 1. d/c offending agent (MAOI)
2. administer PHENTOLAMINE
3. Stabilize fever
medication to reverse hypertensive crisis w/ MAOI? - ANS Phentolamine****
List of common MAOIs (don't need to memorize, just know what it looks like) -
ANS Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (Emsam)
Tranylcypromine (Parnate)
Teratogenic risks of common psych meds (Benzo, Carbamazepine, Lithium, Depakote) -
ANS 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 - ANS 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 - ANS Hepatotoxicity**
3
Page
Pancreatitis**
@COPYRIGHT SIRJOEL 2025/2026
, Carbamazepine (Tegretol) main SE - ANS Agranulocytosis***
Aplastic Anemia***
Steven-Johnson's*** (mainly Asians HLAB-1502 allele)
Aplastic Anemia s/s - ANS pallor, fatigue, HA, fever, nose bleeds, bleeding gums, skin rash,
SOB
Carbamazepine when to d/c - ANS WBC 2000-3000
ANC < 1000
Rash/Steven Johnson's
Or s/s of aplastic anemia or agranulocytosis
What to test prior to prescribing Cabamazepine?? - ANS HLA-B 1502 allele in Asians d/t
Steven's Johnson Syndrome
Clozapine main SE - ANS Risk for NEUTROPENIA --> monitor for s/s of infection***
Neutropenia is monitored only by... - ANS ANC
when to d/c Clozapine? - ANS ANC <1000
WBC 2000-3000
Check ____ before starting female of childbearing age (12-51yr) on psychotropic med -
ANS HCG
4
Page
@COPYRIGHT SIRJOEL 2025/2026