Term
|
Definition
| involuntary contraction of a muscle or muscle group. Usually painful and decreases one's level of functioning. |
|
|
Term
| how do you treat muscle spasms? |
|
Definition
1. immobilization of affected muscles 2. cold compresses 3. physical therapy 4. drug therapy |
|
|
Term
|
Definition
a velocity-dependent increase in resistance to passive movement that affects different muscles to a different extent |
|
|
Term
| muscle spascity is usually due to... |
|
Definition
|
|
Term
| how do you treat muscle spascity? |
|
Definition
physical therapy drug therapy |
|
|
Term
| what should you not do to treat muscle spascity? |
|
Definition
|
|
Term
| which muscle relaxants are approved to treat muscle spascity? |
|
Definition
baclofen dantrolene tizanidine |
|
|
Term
| which drugs are skeletal muscle relaxants? |
|
Definition
baclofen carisoprodol chlorozoxazone cyclobenzaprine dantrolene metaxalone methocarbamol orphenadrine tizanidine |
|
|
Term
| what are some common conditions associated with muscle spascity? |
|
Definition
Multiple Sclerosis Spinal Cord Injury Traumatic Brain Injury Cerebral Palsy Post Stroke Syndrome |
|
|
Term
| what are some common musculoskeletal conditions that can cause tenderness and muscle spasm? |
|
Definition
fibromyalgia tension HAs myofascial pain syndromes mechanical pain (low back or neck) |
|
|
Term
| what is cyclobenzaprine indicated for? |
|
Definition
| relief of acute muscle spasm caused by local tissue trauma or muscle strain |
|
|
Term
What are some cyclobenzaprine contraindications? |
|
Definition
MAOI use in the last 14 days persons w/ a recent MI, cardiac dysrhythmias or overactive thyroid Do not drink alcohol while taking bc it can be additive to the SEs |
|
|
Term
if cyclobenzaprine is prescribed for >1, what do you need to make sure you do? |
|
Definition
taper the dose when discontinuing this prevents HAs, nausea and general discomfort |
|
|
Term
|
Definition
antimuscarnic effects may cause significant sedation confusion transient visual hallucinations potential for cardiac toxicity |
|
|
Term
| cyclobenzaprine pregnancy category |
|
Definition
|
|
Term
| what age groups is cyclobenzaprine not good for? |
|
Definition
children <12 the elderly may be more sensitive to the SEs overdose may be fatal for them |
|
|
Term
| how long should cyclobenzaprine be prescribed for? |
|
Definition
| usually no more than 3 wks |
|
|
Term
| muscle relaxants should be used in conjunction with... |
|
Definition
| rest and physical therapy to receive maximal benefit |
|
|
Term
| chlorzoxazone works to a greater degree at the _____________ than does cyclobenzaprine. |
|
Definition
|
|
Term
| chlorzoxazone works by... |
|
Definition
| blocking nerve impulses sent to the brain from the painful muscle fibers |
|
|
Term
|
Definition
dizziness lightheadedness malaise rarely hyperstimulation, skin rashes petechiae/ecchymoses serious hepatocellular toxicity (not predictable) |
|
|
Term
| when you put a pt on chlorzoxazone, you should advise them to report what symptoms? |
|
Definition
fever N/V/D RUQ pain dark urine jaundice |
|
|
Term
| Chlorzoxazone: concomitant use of ___________ and ________ may have an additive effect. |
|
Definition
| alcohol and CNS depressants |
|
|
Term
| how does carisoprodol work? |
|
Definition
| centrally by blocking pain sensations btwn the nerves and the brain |
|
|
Term
|
Definition
CNS depressant SEs bradycardia hypotension syncope mild GI SEs |
|
|
Term
| methocarbamol may inhibit the effects of _________________ |
|
Definition
pyridostigmine don't use in pts with MG who are being treated w/ it |
|
|
Term
| which muscle relaxant should be given in conjunction with a high fat meal to allow for a more complete absorption (but shorter half life)? |
|
Definition
|
|
Term
| methocarbamol should not be prescribed for women who... |
|
Definition
| are or may become pregnant |
|
|
Term
| SEs of metaxalone include: |
|
Definition
CNS drowsiness dizziness HA N/V hematologic leukopenia, hemolytic anemia |
|
|
Term
| which muscle relaxant has an anxiolytic metabolite called meprobamate? |
|
Definition
Carisoprodol this metabolite is probably why its addictive |
|
|
Term
| Contraindications of carisoprodrol |
|
Definition
pts w/ liver or kidney disease or w/ history of seizures must use a lower dose |
|
|
Term
|
Definition
CNS depressant effects tachycardia postural hypotension use in great caution in a pt w/ an addictive history |
|
|
Term
|
Definition
the first dose has been followed by extreme weakness, transient quadriplegia, ataxia, diplopia, dysarthria and disorientation ideally give them their first dose in the office or make sure they take it at home with someone there, so you can see what happens |
|
|
Term
| which muscle relaxant has the broadest spectrum? |
|
Definition
|
|
Term
|
Definition
NMDA receptor antagonist belonging to the ethanolamine class of antihistamines; isomer of diphenhydramine -- has anticholinergic effects |
|
|
Term
| which muscle relaxant is in the same group as benedryl? |
|
Definition
|
|
Term
| in addition to orphenadrine's skeletal muscle relaxant properties it also has... |
|
Definition
analgesic and local anesthetic effects (used to augment other analgesics in chronic pain management) |
|
|
Term
|
Definition
CNS depression dry mouth abd cramps blurred or double vision constipation difficult urination (bc it has anticholinergic effects) |
|
|
Term
| orphenadrine contraindications |
|
Definition
glaucoma stomach ulcers myasthenia gravis enlarged prostate |
|
|
Term
| which muscle relaxant is closely related to TCAs? |
|
Definition
cyclobenzaprine (problems with cardiac dysrhy) |
|
|
Term
| which muscle relaxant is addictive and controlled in KY? |
|
Definition
|
|
Term
| which muscle relaxant is hepatotoxic? |
|
Definition
|
|
Term
| antihistamines can cause what at both ends of the age spectrum? |
|
Definition
|
|
Term
| what is orphenadrine derived from? |
|
Definition
|
|
Term
| what does dose vary with? |
|
Definition
drug route of administration purpose |
|
|
Term
| for the most part muscle relaxant MOA is __________, but is related in part to their _____________. |
|
Definition
unclear sedative properties |
|
|
Term
| which drug for muscle spasicity is a derivative of GABA and is an agonist at GABAb? |
|
Definition
|
|
Term
| baclofen is indicated for: |
|
Definition
treatment of: spinal cord injuries MS ALS trigeminal neuralgia |
|
|
Term
|
Definition
| acts within the spinal cord to suppress reflexes involved in regulating and controlling muscle mvt and can be administered orally or intrathecally |
|
|
Term
|
Definition
CNS depression mild GI withdrawl sxs if withdrawn too rapidly |
|
|
Term
|
Definition
acts directly on the skeletal mm to suppress Ca release from the s. reticulum this decreases ability of mm to contract |
|
|
Term
| why would you use dantrolene? |
|
Definition
to reduce spasticity in post stroke pts paraplegics pts w/ CP and MS specific antidote for malignant hyperthermia useful in management of neuroleptic malignant syndrome |
|
|
Term
| what is neuroleptic malignant syndrome caused by? |
|
Definition
anti-psychotic drugs lead pipe rigidity and inc body heat |
|
|
Term
| chemically dantrolene is a _____________ derivative |
|
Definition
hydantonin but its not used in treating seizure disorders |
|
|
Term
|
Definition
HEPATOTOXICITY mm weakness (most common) drowsiness, confusion, depression speech and visual distrubances diarrhea |
|
|
Term
| which drug for mm spasticity can cause heptatotoxicity? |
|
Definition
|
|
Term
| dantrolene drug interactions |
|
Definition
dantrolene + CCB can lead to various cardiovascular abnormalities, including dysrhythmias, hyperkalemia estrogens can enhance the liver toxicity of dantrolene |
|
|
Term
| what is the MOA of tizanidine? |
|
Definition
| centrally acting alpha-2 adrenergic agonist |
|
|
Term
| tizanidine is used to treat... |
|
Definition
|
|
Term
| which muscle spasticity drug can cause liver injury, hallucinations and delusions? |
|
Definition
|
|
Term
| if you use tizanidine for an extended period of time what do you run the risk of? |
|
Definition
withdrawl rebound hypertension tachycardia |
|
|
Term
|
Definition
| an adaptive response that prepares one to react to threatening events |
|
|
Term
| what is the difference btwn fear and anxiety? |
|
Definition
fear is in response to something that is known anxiety is in response to something that is unknown |
|
|
Term
| what are some characteristics of anxiety? |
|
Definition
physiologic arousal apprehension and/or fear hypervigilance |
|
|
Term
|
Definition
| a maladaptive response to psychological stress |
|
|
Term
| what are some characterisitics of chronic anxiety? |
|
Definition
physical sxs such as diarrhea, sweating, tremors, dizziness, palpitations long term may contribute to heart disease, or substance abuse |
|
|
Term
how does the amygdala mediate the manifestations of anxiety? |
|
Definition
| by potentiating the memory of AEs that establish anticipatory anxiety |
|
|
Term
| what are the 2 components of the experience of anxiety? |
|
Definition
1. awarenss of the physiological sensations eg sweating and palpitations 2. awareness of being nervous or frightened |
|
|
Term
| what does anxiety affect? |
|
Definition
thinking perception learning |
|
|
Term
| anxiety tends to produce: |
|
Definition
confusion and distortions of perceptions not only of time and space but of people and the meaning of events |
|
|
Term
| what are the 3 major NTs assc with anxiety? |
|
Definition
NE Serotonin Gamma-aminobutyric acid (GABA) |
|
|
Term
| which NT has a lot to do with emotions? |
|
Definition
|
|
Term
| how do we know that GABA is affects anxiety? |
|
Definition
bc of the efficacy of benzodiazepines which enhance activity of GABA in the txt of some anxiety disorders |
|
|
Term
| about ___ of all pts with panic disorder have a least ___ affected relative |
|
Definition
|
|
Term
| what are some examples of anxiety disorders? |
|
Definition
panic disorder w/ or w/o agoraphobia agoraphobia w/o panic disorder specific and social phobias OCD PTSD anxiety due to general medical condition substance induced anxiety disorder anxiety not otherwise specified |
|
|
Term
| how do you manage anxiety disorders? |
|
Definition
first, make the correct diagnosis psychotherapy pharmacotherapy |
|
|
Term
| which benzodiazapines are anxiolytics? |
|
Definition
diazepam alprazolam lorazepam clorazepate chlordiazepoxide (1st one) |
|
|
Term
| which benzodiazepines are hypnotics (sleeping pills)? |
|
Definition
oxazepam temazepam triazolam flurazepam estazolam |
|
|
Term
| which benzos are for seizures? |
|
Definition
|
|
Term
| which benzos are used as an anesthetic? |
|
Definition
|
|
Term
| which benzos are frequently used in alcohol detox units? |
|
Definition
chlordiazepoxide lorazepam oxazepam |
|
|
Term
| which benzo is also prescribed for muscle relaxation? |
|
Definition
|
|
Term
how should you choose which benzodiazepine to use? |
|
Definition
| based on its onset and duration of action |
|
|
Term
| how are benzos metabolized? |
|
Definition
in the liver either by: P450 system or phase II conjugation |
|
|
Term
| which benzos are metabolized by conjugation? |
|
Definition
lorazepam oxazepam temazepam safer for use in the elderly |
|
|
Term
| which benzos are safer for use in the elderly? |
|
Definition
those metabolized by conjugation lorazepam oxazepam temazepam |
|
|
Term
| what is the MOA of benzos? |
|
Definition
bind to receptors on the GABAa-chloride ionophore they cause channels to open more frequently, more Cl gets to go through hyperpolarizes secondly (minor) increases the inhibitory effect of adenosine on neurons that release ACh, thought to cause arousal |
|
|
Term
lower doses of BZDPs are ______________ higher doses produce _______________ |
|
Definition
sedative and anxiolytic hypnosis and anesthesia |
|
|
Term
| if you pick the right drug, what can BZDPs do? |
|
Definition
| relieve anxiety w/o causing much sedation |
|
|
Term
| when would BZDPs cause resp depression, coma or death? |
|
Definition
| when they are combined with other CNS depressants |
|
|
Term
| which group of drugs can cause retrograde amnesia? |
|
Definition
BZDPs they interfere with the formation of new memories |
|
|
Term
|
Definition
CNS depression impair cognitive processing interfere w/ driving and other psychomotor skills long acting drugs may cause drug hangover respiratory depression w/ IV admin mild euphoric effect which leads to behavioral inhibitions long term use may lead to physical dependence |
|
|
Term
| what is the antidote for BZDPs? |
|
Definition
flumazenil -- Romazicon SEs seizures, dysrhythmias, blurred vision, dizziness |
|
|
Term
|
Definition
to treat: anxiety disorders insomnia muscle spasm/spasticity seizure disorders alcohol detox panic disorders anesthesia |
|
|
Term
| what is the MOA of barbiturates? |
|
Definition
1. bind to GABAa-chloride ionophore to increase affinity 2. increase the duration of time the channel remains open 3. directly increases chloride influx |
|
|
Term
| which is the difference in the MOAs btwn BZDPs and barbiturates? |
|
Definition
barbiturates not only bind to the GABAa-chloride ionophore but it also keeps the Cl channel open longer and increases the chloride influx |
|
|
Term
| what makes barbiturates pretty toxic? |
|
Definition
it has a linear dose-response curve as the dose increases the pt progresses in sedative effects from sedation to resp depression to coma to death |
|
|
Term
| which barbiturate is most frequently used? |
|
Definition
phenobarbital (antiseizure med) |
|
|
Term
| which drugs are barbiturates? |
|
Definition
pentobarbital thiopental amobarbital secobarbital phenobarbital |
|
|
Term
| which barbiturate is most likely to be abused? |
|
Definition
|
|
Term
are BZDPs or barbiturates more toxic and sedating? |
|
Definition
|
|
Term
| how do the barbiturates effect sleep? |
|
Definition
|
|
Term
| why do you need to taper pts off barbiturates slowly? |
|
Definition
| bc they can cause tolerance and physical dependence// withdrawl syndrome |
|
|
Term
| which disorder do barbiturates exacerbate? |
|
Definition
prophyria where you can't metabolize bilirubin |
|
|
Term
| why do barbiturates have a lot of drug interactions? |
|
Definition
bc they are metabolized by the P450 system and may induce their own and other drug's metabolism |
|
|
Term
| which barbiturates are used for the txt of insomnia? |
|
Definition
pentobarb secobarb (they are schedule 2) |
|
|
Term
| which barbiturate is known as the "truth serum"? |
|
Definition
thiopental sometimes used before induction of anesthesia |
|
|
Term
|
Definition
euphoria elation uninhibited behavior (makes them candidates for abuse) |
|
|
Term
| which barbiturate is a schedule 4? |
|
Definition
|
|
Term
| larger doses of barbiturates can do what? |
|
Definition
depress the respiratory and nervous system functions abusers rapidly develop a tolerance thus fatal overdose or coma can easily occur |
|
|
Term
| what occurs with withdrawl syndrome from barbiturates? |
|
Definition
anxiety tachypnea irritability tachycardia muscle pain tremors Nausea hallucinations confusion seizures death insomnia vivid dreaming nightmares ] |
|
|
Term
| which hypnotic is the most used in the hospital? |
|
Definition
antihistamines like benedryl its capitalizing on a SE |
|
|
Term
|
Definition
| works similar to BZDPs by activating the omega1 BZDP receptor on the GABAa-chlorine ionophore |
|
|
Term
| how does zolpidem (ambien) effect sleep? |
|
Definition
preserve deep sleep no significant effect on REM sleep |
|
|
Term
| why is zolpidem good if you pt says they can't fall asleep? |
|
Definition
bc it has a rapid onset and short duration of action |
|
|
Term
| how long should you use zolpidem? |
|
Definition
|
|
Term
| what should you not use when you are on zolpidem? |
|
Definition
ETOH other CNS depressants |
|
|
Term
| what schedule are the hypnotic drugs (excluding antihistamines)? |
|
Definition
|
|
Term
| zaleplon (sonata) has similar actions and effects to what other drug? |
|
Definition
|
|
Term
| when would you use zaleplon? |
|
Definition
in a pt who is having problems falling asleep it does not increase sleep duration |
|
|
Term
| what is the recommended duration of txt of zaleplon? |
|
Definition
|
|
Term
|
Definition
anterograde amnesia tolerance physical and psychological dependence |
|
|
Term
| how is zaleplon metabolized? |
|
Definition
|
|
Term
|
Definition
MOA unknown; probably interacts w GABA receptors a new chemical class of hypnotics appears to be quite safe short term only 45 minutes before bed |
|
|
Term
| about what percentage of people w/ depression show improvement with ANY of several antidepressant meds? |
|
Definition
|
|
Term
| combining antidepressant drugs with _____________ is synergistic |
|
Definition
|
|
Term
| which TCAs are the most common? |
|
Definition
amitriptyline desipramine nortriptyline imipramine clomipramine doxepin |
|
|
Term
| what do TCAs generally end in? |
|
Definition
|
|
Term
| TCAs are sometimes used as adjuncts in... |
|
Definition
|
|
Term
|
Definition
blockade of reuptake of either NE or serotonin from the synapse back into the nerve terminal w/o blocking the reuptake of dopamine |
|
|
Term
| are TCAs more potent at blocking the reuptake of NE or serotonin? |
|
Definition
|
|
Term
| TCAs have may active __________ |
|
Definition
metabolites (potential for drug interactions) |
|
|
Term
most TCAs are extensively... |
|
Definition
|
|
Term
| why are they called TCAs? |
|
Definition
| bc of their triple ring structure |
|
|
Term
| as a rule, TCAs have ______ half-lives |
|
Definition
long ranging from 1-3 days |
|
|
Term
| TCAs improve depressive illnesses in ____% of pts? |
|
Definition
|
|
Term
| how long does it normally take for TCAs to have their maximal effect? |
|
Definition
|
|
Term
|
Definition
propensity to commit suicide |
|
|
Term
|
Definition
sedation wt gain dry mouth constipation urinary retention blurred vision memory impairment sinus tachycardia orthostatic hypotension |
|
|
Term
| which TCA SE is potentially a severe problem in the elderly? |
|
Definition
|
|
Term
| if pts have reexisting cardiac problems, what can be seen with TCA use? |
|
Definition
|
|
Term
| which SE is likely to make TCA users less compliant? |
|
Definition
wt gain and sexual dysfunction |
|
|
Term
| what is an important central SE of TCAs? |
|
Definition
| induction of mania or hypomania in depressed pts with bipolar disorder |
|
|
Term
| TCA-induced toxicity of the CNS can produce... |
|
Definition
delirium which is preceded by a worsening of the depression or psychosis |
|
|
Term
| poisoning accounts for ____ of all suicides and ____ are the most commonly used drugs in these victims. |
|
Definition
|
|
Term
| what can TCA overdose cause? |
|
Definition
coma cardiac dysrhythmias death |
|
|
Term
| what is a lethal dose of TCA? |
|
Definition
| no more than 10-20 times greater than a standard daily dose |
|
|
Term
| what pregnancy category are TCAs? |
|
Definition
C except for imipramine, nortriptyline and amitripyline which are D |
|
|
Term
which drug interaction w/ TCA is very serious? |
|
Definition
TCA + MAOIs make sure you have a 2 wk wash out |
|
|
Term
| what is the difference btwn SSRIs and TCAs? |
|
Definition
SSRIs are selective for serotonin reuptake have less SEs and cause less sedation but just as effective TCAs are nonspecific for NE and serotonin reuptake |
|
|
Term
| what is the prototype for SSRIs? |
|
Definition
|
|
Term
|
Definition
fluoxetine paroxetine fluvoxamine citalopram escitalopram |
|
|
Term
| are all SSRIs structurally similar? |
|
Definition
|
|
Term
| which drugs are first choice for people with depression? |
|
Definition
|
|
Term
| why don't SSRIs make you drowsy? |
|
Definition
| bc they have little to no affinity for cholinergic, beta adrenergic or histamine receptors |
|
|
Term
| why should SSRIs be taken first thing in the morning? |
|
Definition
|
|
Term
SSRIs are well tolerated by the ____________ |
|
Definition
|
|
Term
| how long may it take for SSRIs to have their maximal effect? |
|
Definition
|
|
Term
|
Definition
increased alertness nervousness, dizziness, insomnia, and male sexual dysfunction many SEs subside with continued use |
|
|
Term
| SSRIs should be used with caution in pts with... |
|
Definition
seizure disorders hepatic disorders bipolor disorders |
|
|
Term
how are SSRIs metabolized? |
|
Definition
|
|
Term
| what is unique about fluoxetine? |
|
Definition
it has a 60 hours half life and an active metabolite with a half life of 192 hours not used as much as the other SSRIs |
|
|
Term
| if you want to switch a pt from a MAOI to a SSRI and vice versa how long must the wash out period be? |
|
Definition
|
|
Term
|
Definition
depression eating disorders anxiety disorders fibromyalgia autism PMS |
|
|
Term
| which SSRI is assc with more drug interactions than any other? |
|
Definition
|
|
Term
| Fluoxetine has caused ________ in some pts -- watch out for persistant _______________ |
|
Definition
|
|
Term
| which SSRIs has the fewest drug interactions? |
|
Definition
|
|
Term
| which SSRI can inhibit its own metabolism? |
|
Definition
|
|
Term
| which SSRI is more sedating than the others? |
|
Definition
paroxetine which makes its good for combination of anxiety and depression |
|
|
Term
| which SSRI is your last choice? |
|
Definition
|
|
Term
| which SSRI may have more GI effects? |
|
Definition
|
|
Term
| abrupt discontinuation of _____________ is assc with a flu-like syndrome |
|
Definition
|
|
Term
| Escitalopram is an isomer of ___________ |
|
Definition
|
|
Term
| which SSRIs would you use for OCD? |
|
Definition
fluvoxamine paroxetine sertraline fluoxetine |
|
|
Term
| which SSRIs would you use to treat GAD? |
|
Definition
|
|
Term
| which SSRIs would you use to treat bulimia? |
|
Definition
|
|
Term
| which SSRIs would you use to treat panic disorders? |
|
Definition
fluoxetine paroxetine sertraline fluvoxamine |
|
|
Term
| which SSRIs are used to treat PMDS? |
|
Definition
fluoxetine paroxetine sertraline |
|
|
Term
| which SSRI is used to treat BDD? |
|
Definition
|
|
Term
| which SSRI is used to treat PTSD and social anxiety? |
|
Definition
|
|
Term
| which SSRI is used to treat hypochondriasis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
inhibits reuptake of serotonin, NE and +- DA no significant P450 effects antidepressant |
|
|
Term
|
Definition
classified as an SSNRI antidepressant |
|
|
Term
|
Definition
depression diabetic peripheral neuropathic pain |
|
|
Term
|
Definition
most common = nausea dry mouth constipation dec appetite increased sweating |
|
|
Term
|
Definition
|
|
Term
|
Definition
antidepressant blocks presynaptic alpha2-adrenergic receptors selectively antagonizes serotonin 2&3 receptors usually adjunctive |
|
|
Term
| mirtazapine is metabolized by: |
|
Definition
|
|
Term
|
Definition
depression adjunctive for resistant depression depression w/ anxiety preoperative anxiety depression w/ insomnia |
|
|
Term
|
Definition
drowsiness dry mouth inc appetite wt gain dizziness elevations in cholesterol, trigs and ALT agranulocytosis (bone marrow suppression) low incidence of sexual dysfunction |
|
|
Term
| if you are taking mirazapine and you get a __________ you should come in |
|
Definition
|
|
Term
| trazodone is ____________ unrelated to other antidepressants |
|
Definition
|
|
Term
|
Definition
not fully understood inhibits serotonin uptake |
|
|
Term
|
Definition
drowsiness other typical CNS effects priapism |
|
|
Term
|
Definition
depression insomnia anxiety (they respond early here) |
|
|
Term
| what is trazodone usually prescribed for? |
|
Definition
|
|
Term
| bupropion is __________ to other antidepressants |
|
Definition
|
|
Term
|
Definition
weakly inhibits reuptake of NE and serotonin major effects is inhibition of dopamine reuptake pumps few anticholinergic, sedative or CV SEs |
|
|
Term
| which type of bupropion helps people quit smoking? |
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Definition
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Term
|
Definition
agitation insomnia tremor rarely seizures |
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Term
|
Definition
depression SAD quitting smoking |
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Term
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Definition
MAOI rec for use with atypical depression or typical depression when others fail lots of food and drug interactions |
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Term
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Definition
MAOB inhibitor transdermal patch at higher doses it loses its selectivity |
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Term
| what is one of the most severe forms of mental illness? |
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Definition
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Term
| bipolar disorder is characterized by... |
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Definition
| recurrent episodes of mania and (more often) depression |
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Term
| if bipolor disorder goes untreated, what is the rate of suicide? |
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Definition
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Term
| bipolar disorder is ________________ and runs in _____________ |
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Definition
life long runs in families |
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Term
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Definition
increased energy, activity and restlessness overly good, euphoric mood extreme irritability racing thoughts distractibility little sleep needed unrealistic beliefs in one's abilities and powers poor judgment spending sprees increased sexual drive abuse of drugs, alcohol and sleep meds provocative, intrusive, aggresive behavior denial that anything is wrong |
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Term
| how do you diagnose a manic episode? |
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Definition
| if elevated mood occurs with 3+ of the sxs most of the day, nearly every day, for 1 week or longer |
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Term
| A depressive episode is diagnosed if... |
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Definition
| 5+ of the sxs last most of the day, nearly every day, for a period of 2 weeks or longer |
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Term
| what is rapid cycling bipolar? |
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Definition
| when 4+ episodes of illness occur within a 12-month period |
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Term
| what is the most commonly used drug for bipolar? |
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Definition
lithium followed by carbamazepine and valproic acid |
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Term
| in mania a __________________ and/or ____________ is often added to the mood stabilzer? |
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Definition
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Term
| Bipolar: in depression a ______________ and/or ____________ is often added to the mood stabilzer |
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Definition
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Term
| what drugs can trigger mania? |
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Definition
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Term
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Definition
increases the uptake of NE and serotonin and thereby reduces their actions it reduces release of NE from synaptic vesicles and inhibits production of cAMP |
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Term
| what do you need to make sure does not change when prescribing lithium? |
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Definition
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Term
| why is lithium often seen taken with synthroid and a beta blocker? |
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Definition
bc the synthroid is used to treat the hypothyroidism caused by lithium and the beta blocker is used to treat the hand tremor caused by lithium |
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