front 1 Define bipolar I | back 1 at least one episode of mania, and usually, bouts of intense depression (a depressive episode is not required for diagnosis) |
front 2 For bipolar I disorder, mania must be associated with at least one of the following: | back 2 significant impairment in social/work functioning, psychosis/delusions or requires hospitalization |
front 3 Define bipolar II | back 3 at least one episode of hypomania (lasting ≥ 4 consecutive days) and at least one depressive episode (lasting ≥ 2 weeks) |
front 4 For bipolar disorder II, hypomania | back 4 does not affect social/work functioning, does not cause psychosis nor requires hospitalization |
front 5 Define bipolar depression | back 5 predominant symptoms of a depressive episode include feelings of sadness or depressed mood and/or loss of interest |
front 6 Define psychosis | back 6 severe mental condition where there is a loss of contact with reality, involves abnormal thinking and perception (ex: hallucinations and delusions) |
front 7 Define bipolar disorder | back 7 characterized by fluctuations in mood from an extremely sad or hopeless state to an abnormally elevated, overexcited or irritable mood called mania or hypomania |
front 8 Define mania | back 8 abnormally elevated irritable mood for at least a week (or any duration if hospitalization is needed) |
front 9 Diagnosis of mania | back 9 exhibits ≥ 3 symptoms (if mood is only irritable, exhibits ≥ 4 symptoms) |
front 10 Symptoms of mania | back 10 inflated self-esteem, needs less sleep, more talkative than normal, jumping from topic to topic, easily distracted, increase in goal-directed activity, high-risk pleasurable activities (buying sprees, gambling) |
front 11 What is the goal of treatment for bipolar disorder | back 11 stabilize the mood without inducing a depressive or manic state |
front 12 Which mood stabilizers treat both mania and depression, without inducing either state | back 12 lithium and antiepileptic drugs (valproate, lamotrigine and carbamazepine) |
front 13 Acute first-line treatment for manic episode | back 13 antipsychotic (olanzapine, risperidone), lithium and valproate (combination of an antipsychotic + lithium or valproate is preferred for severe episodes) |
front 14 Acute first-line treatment for depressive episode | back 14 antipsychotic (quetiapine, lurasidone) (lithium, valproate or lamotrigine can be added or used as alternatives) |
front 15 MedGuides are required with all | back 15 antidepressants and antipsychotics |
front 16 Which antiepileptic drug requires a slow titration due to the risk of a severe rash | back 16 lamotrigine |
front 17 Brand name for lamotrigine | back 17 Lamictal |
front 18 Brand name for valproate/valproic acid derivatives | back 18 Depakote |
front 19 Brand name for carbamazepine | back 19 Equetro |
front 20 Major concern with antipsychotics is the risk of | back 20 EPS |
front 21 What generation of antipsychotics have a higher risk of EPS | back 21 first-generation |
front 22 Brand name of aripiprazole | back 22 Abilify |
front 23 Brand name of olanzapine | back 23 Zyprexa |
front 24 Brand name of quetiapine | back 24 Seroquel |
front 25 Brand name of risperidone | back 25 Risperdal |
front 26 Brand name of ziprasidone | back 26 Geodon |
front 27 Brand name lurasidone | back 27 Latuda |
front 28 MOA of lithium | back 28 influencing the reuptake of serotonin and/or NE or by moderating glutamate levels in the brain (glutamate is the primary excitatory neurotransmitters, so high levels can cause mania) |
front 29 Brand name for lithium | back 29 Lithobid |
front 30 Therapeutic range of lithium | back 30 0.6 - 1.2 mEq/L (trough level) |
front 31 Signs/symptoms of lithium level >1.5 mEq/L | back 31 ataxia, coarse hand tremor, vomiting, persistent diarrhea, confusion, sedation |
front 32 Signs/symptoms of lithium level >2.5 mEq/L | back 32 CNS depression, arrhythmia, seizure, coma |
front 33 Lithium levels increase with | back 33 decreased salt intake, sodium loss (ACEi, ARBs, thiazide diuretics), NSAIDs |
front 34 Lithium levels decrease with | back 34 increased salt intake, caffeine and theophylline |
front 35 5 mL lithium citrate syrup = | back 35 8 mEq of lithium ion |
front 36 8 mEq of lithium ion = | back 36 300 mg lithium carbonate tabs/caps |
front 37 increased risk of neurotoxicity if lithium is taken with | back 37 verapamil, diltiazem, phenytoin and carbamazepine |
front 38 Which antipsychotic has the most favorable safety profile in pregnancy | back 38 lurasidone |