GEORGETTE MODULE 1 -2 EXAM
QUESTIONS & DETAILED COMPLETE
SOLUTIONS (VERIFIED)
Lithium toxicity can occur when this level reaches ?. - correct answer ✔✔1.5 mEq or higher
Gold standard for treatment of manic episodes. - Evidence of anti-suicidal effects. - correct
answer ✔✔Lithium
- Neuroprotective treatment of choice for bipolar disorder (protects nerve cells from damage) -
correct answer ✔✔Lithium
baseline labs to get prior to starting lithium: - correct answer ✔✔TSH, 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) - correct answer ✔✔Lithium side effect
Examples of things that can decrease renal clearance, by possibly increasing concentration of
drugs that are excreted by kidneys (for example lithium - correct answer ✔✔Kidney disease or
drugs (such as NSAIDs (ibuprofen, Indocin), thiazides (HCTZ), ACE inhibitors (lisinopril),)
Signs and symptoms of lithium toxicity: - correct 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 - correct answer ✔✔stop 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. - correct
answer ✔✔Hypertensive crisis
- life threatening and cannot be reversed unless more MAO Is produced by the body - correct
answer ✔✔Hypertensive crisis
- Hypertensive crisis and death can occur when MAOIs are taken in conjunction with certain
meds - correct answer ✔✔o 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 - correct 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: - correct answer ✔✔- stop the MAOI
- give phentolamine
- stabilize fever
- review diet in Med guidelines with patient
Teratogenic risk Benzodiazepine - correct answer ✔✔floppy baby syndrome, cleft palate
Teratogenic risk Carbamazepine (Tegretol) - correct answer ✔✔neural tube defects
Teratogenic risk Lithium - correct answer ✔✔- Epstein anomaly
Teratogenic risk divalproex sodium (Depakote) - correct answer ✔✔- neural tube defects,
*specifically spina bifida, atrial septal defect, cleft palate, impossible long term developmental
deficits
Lamictal black box warning for - correct answer ✔✔Stevens Johnson syndrome
- signs and symptoms of Steven Johnson syndrome - correct answer ✔✔o Fever
o sore throat
o tongue swelling
o facial swelling
o rash
o skin sloughing
o Prodromal headache
o Malaise
QUESTIONS & DETAILED COMPLETE
SOLUTIONS (VERIFIED)
Lithium toxicity can occur when this level reaches ?. - correct answer ✔✔1.5 mEq or higher
Gold standard for treatment of manic episodes. - Evidence of anti-suicidal effects. - correct
answer ✔✔Lithium
- Neuroprotective treatment of choice for bipolar disorder (protects nerve cells from damage) -
correct answer ✔✔Lithium
baseline labs to get prior to starting lithium: - correct answer ✔✔TSH, 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) - correct answer ✔✔Lithium side effect
Examples of things that can decrease renal clearance, by possibly increasing concentration of
drugs that are excreted by kidneys (for example lithium - correct answer ✔✔Kidney disease or
drugs (such as NSAIDs (ibuprofen, Indocin), thiazides (HCTZ), ACE inhibitors (lisinopril),)
Signs and symptoms of lithium toxicity: - correct 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 - correct answer ✔✔stop 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. - correct
answer ✔✔Hypertensive crisis
- life threatening and cannot be reversed unless more MAO Is produced by the body - correct
answer ✔✔Hypertensive crisis
- Hypertensive crisis and death can occur when MAOIs are taken in conjunction with certain
meds - correct answer ✔✔o 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 - correct 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: - correct answer ✔✔- stop the MAOI
- give phentolamine
- stabilize fever
- review diet in Med guidelines with patient
Teratogenic risk Benzodiazepine - correct answer ✔✔floppy baby syndrome, cleft palate
Teratogenic risk Carbamazepine (Tegretol) - correct answer ✔✔neural tube defects
Teratogenic risk Lithium - correct answer ✔✔- Epstein anomaly
Teratogenic risk divalproex sodium (Depakote) - correct answer ✔✔- neural tube defects,
*specifically spina bifida, atrial septal defect, cleft palate, impossible long term developmental
deficits
Lamictal black box warning for - correct answer ✔✔Stevens Johnson syndrome
- signs and symptoms of Steven Johnson syndrome - correct answer ✔✔o Fever
o sore throat
o tongue swelling
o facial swelling
o rash
o skin sloughing
o Prodromal headache
o Malaise
