NUR 354
NUR 354 FINAL EXAM GRADED A+ 2025
Bipolar I disorder
- most severe form
- at least one manic episode possibly w/preceding or following hypomanic or
major depressive episodes
- Marked by one of more manic episodes, potentially with a high risk of
suicide and risky behaviors. There’s a significant overlap with the schizophrenia
genetics
Ex: John, a 30-year-old, exhibits extreme mood swings, engaging in extravagant
activities during manic phases and experiencing severe depression at other times.
Bipolar II disorder
- at least 1 hypomanic & 1 major depressive episode w/ a strong link to major
depressive disorder and challenges like substance use and eating disorders during
different mood phases.
- hypomania is less severe than mania w/out psychotic features but depressive
episodes can be just as disabling as in bipolar I
EX: Sarah, a 25-year-old, experiences periods of elevated mood and productivity
(hypomania), as well as significant depressive episodes.
Lithium
Bipolar depression: while not the primary indication, lithium can mitigate
depressive episodes
acute mania: FDA approved for rapid symptom control
Bipolar maintenance: prevents mood swings FDA approved for lone term use
Anticonvulsant mood stabilizers
divalproex sodium (depakote) VALPROATE
NUR 354
, NUR 354
Acute Mania: FDA-approved for rapid symptom control.
Bipolar Maintenance: Used to prevent episode recurrence.
Use: effective in treating mania and preventing future episodes. Often chosen for
those unresponsive to the lithium.
Dosage: begins between 750 mg-1000 mg daily, with adjustments to maintain
therapeutic blood levels (50-125 µg/mL).
Considerations: requires monitoring for liver function and blood levels to mitigate
potential toxicity
Anticonvulsant mood stabilizers
Carbamazepine (Equetro)
Acute Mania: FDA-approved for controlling manic and mixed episodes.
Bipolar Maintenance: Helps in reducing the likelihood of future episodes.
Use targets manic and mixed episodes. Considered when lithium or valproate is
ineffective or intolerable
Dosage: starts at 200 mg twice daily, with potential increases. Therapeutic levels
range from 4-12 µg/mL
Considerations: demands regular blood level checks and can induce its own
metabolism, necessitating dosage adjustments over time
Lamotrigine (Lamictal) for BD
Bipolar Depression: Especially effective for depressive phases; FDA-approved.
Bipolar Maintenance: FDA-approved for delaying depressive episodes.
Use: primarily for long term maintenance, delaying the reccurence of mood
NUR 354
NUR 354 FINAL EXAM GRADED A+ 2025
Bipolar I disorder
- most severe form
- at least one manic episode possibly w/preceding or following hypomanic or
major depressive episodes
- Marked by one of more manic episodes, potentially with a high risk of
suicide and risky behaviors. There’s a significant overlap with the schizophrenia
genetics
Ex: John, a 30-year-old, exhibits extreme mood swings, engaging in extravagant
activities during manic phases and experiencing severe depression at other times.
Bipolar II disorder
- at least 1 hypomanic & 1 major depressive episode w/ a strong link to major
depressive disorder and challenges like substance use and eating disorders during
different mood phases.
- hypomania is less severe than mania w/out psychotic features but depressive
episodes can be just as disabling as in bipolar I
EX: Sarah, a 25-year-old, experiences periods of elevated mood and productivity
(hypomania), as well as significant depressive episodes.
Lithium
Bipolar depression: while not the primary indication, lithium can mitigate
depressive episodes
acute mania: FDA approved for rapid symptom control
Bipolar maintenance: prevents mood swings FDA approved for lone term use
Anticonvulsant mood stabilizers
divalproex sodium (depakote) VALPROATE
NUR 354
, NUR 354
Acute Mania: FDA-approved for rapid symptom control.
Bipolar Maintenance: Used to prevent episode recurrence.
Use: effective in treating mania and preventing future episodes. Often chosen for
those unresponsive to the lithium.
Dosage: begins between 750 mg-1000 mg daily, with adjustments to maintain
therapeutic blood levels (50-125 µg/mL).
Considerations: requires monitoring for liver function and blood levels to mitigate
potential toxicity
Anticonvulsant mood stabilizers
Carbamazepine (Equetro)
Acute Mania: FDA-approved for controlling manic and mixed episodes.
Bipolar Maintenance: Helps in reducing the likelihood of future episodes.
Use targets manic and mixed episodes. Considered when lithium or valproate is
ineffective or intolerable
Dosage: starts at 200 mg twice daily, with potential increases. Therapeutic levels
range from 4-12 µg/mL
Considerations: demands regular blood level checks and can induce its own
metabolism, necessitating dosage adjustments over time
Lamotrigine (Lamictal) for BD
Bipolar Depression: Especially effective for depressive phases; FDA-approved.
Bipolar Maintenance: FDA-approved for delaying depressive episodes.
Use: primarily for long term maintenance, delaying the reccurence of mood
NUR 354
