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Questions and Answers
What is the lifetime regimen of medications for bipolar disorder?
What is the lifetime regimen of medications for bipolar disorder?
Which element is lithium similar to?
Which element is lithium similar to?
What is the response rate in acute mania to lithium therapy?
What is the response rate in acute mania to lithium therapy?
What do lithium and anticonvulsants protect against?
What do lithium and anticonvulsants protect against?
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What is administered in addition to bipolar medications if a client exhibits psychosis during acute mania or depression?
What is administered in addition to bipolar medications if a client exhibits psychosis during acute mania or depression?
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What does lithium compete for at receptor sites?
What does lithium compete for at receptor sites?
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What can lithium do in addition to treating the range of bipolar behaviors?
What can lithium do in addition to treating the range of bipolar behaviors?
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Which atypical antipsychotic drug is approved by the FDA for the treatment of acute manic and mixed bipolar disorder in children and adolescents aged 8 to 17 years?
Which atypical antipsychotic drug is approved by the FDA for the treatment of acute manic and mixed bipolar disorder in children and adolescents aged 8 to 17 years?
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Which atypical antipsychotic drug has a Black Box Warning regarding the risk of compulsive or uncontrollable urges to gamble, shop, binge eat, or have sex?
Which atypical antipsychotic drug has a Black Box Warning regarding the risk of compulsive or uncontrollable urges to gamble, shop, binge eat, or have sex?
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Which atypical antipsychotic drug has a Black Box Warning concerning a drug reaction with eosinophilia and systemic symptoms (DRESS)?
Which atypical antipsychotic drug has a Black Box Warning concerning a drug reaction with eosinophilia and systemic symptoms (DRESS)?
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Which atypical antipsychotic drug is not recommended for dementia-related psychosis?
Which atypical antipsychotic drug is not recommended for dementia-related psychosis?
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Which atypical antipsychotic drug is associated with a Black Box Warning reporting increasing mortality in elderly patients with dementia-related psychosis?
Which atypical antipsychotic drug is associated with a Black Box Warning reporting increasing mortality in elderly patients with dementia-related psychosis?
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Which atypical antipsychotic drug is excreted in the urine and feces and has antagonist effects on serotonin and dopamine?
Which atypical antipsychotic drug is excreted in the urine and feces and has antagonist effects on serotonin and dopamine?
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Which atypical antipsychotic drug is well absorbed, highly protein bound, and metabolized in the liver?
Which atypical antipsychotic drug is well absorbed, highly protein bound, and metabolized in the liver?
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Which anticonvulsant is approved by the FDA for treating bipolar disorder and is typically used for patients who do not respond to lithium?
Which anticonvulsant is approved by the FDA for treating bipolar disorder and is typically used for patients who do not respond to lithium?
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Which anticonvulsant is being studied and used off-label for its effects in bipolar disorder but does not have FDA approval for this use?
Which anticonvulsant is being studied and used off-label for its effects in bipolar disorder but does not have FDA approval for this use?
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What is crucial for lithium therapy due to its narrow therapeutic range and individual variations?
What is crucial for lithium therapy due to its narrow therapeutic range and individual variations?
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Why is adequate renal function essential for lithium therapy?
Why is adequate renal function essential for lithium therapy?
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What should be done before starting lithium therapy?
What should be done before starting lithium therapy?
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What is the therapeutic range for serum lithium levels?
What is the therapeutic range for serum lithium levels?
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What should patient teaching emphasize regarding lithium therapy?
What should patient teaching emphasize regarding lithium therapy?
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What are common adverse effects of lithium?
What are common adverse effects of lithium?
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When is discontinuation of lithium necessary?
When is discontinuation of lithium necessary?
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What is the recommended action regarding lithium use during pregnancy?
What is the recommended action regarding lithium use during pregnancy?
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What is the half-life of lithium?
What is the half-life of lithium?
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What is the primary route of excretion for lithium?
What is the primary route of excretion for lithium?
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What percentage of people with bipolar illness respond effectively to lithium?
What percentage of people with bipolar illness respond effectively to lithium?
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What is the onset of action for lithium?
What is the onset of action for lithium?
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Which drugs are used as mood stabilizers for bipolar illness, each requiring specific therapeutic level monitoring and baseline laboratory testing?
Which drugs are used as mood stabilizers for bipolar illness, each requiring specific therapeutic level monitoring and baseline laboratory testing?
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Which drugs are adjunctive medications used alongside mood stabilizers or antidepressants to treat bipolar disorder?
Which drugs are adjunctive medications used alongside mood stabilizers or antidepressants to treat bipolar disorder?
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What is the recommended action for lithium use during pregnancy?
What is the recommended action for lithium use during pregnancy?
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What is the onset of action for lithium?
What is the onset of action for lithium?
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What percentage of people with bipolar illness respond effectively to lithium?
What percentage of people with bipolar illness respond effectively to lithium?
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How is lithium excreted from the body?
How is lithium excreted from the body?
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What is the half-life of lithium?
What is the half-life of lithium?
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Which medication is used to treat and prevent manic episodes in bipolar disorder?
Which medication is used to treat and prevent manic episodes in bipolar disorder?
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What is the usual practice for long-term therapy of bipolar disorder with lithium?
What is the usual practice for long-term therapy of bipolar disorder with lithium?
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Study Notes
Lithium Therapy Considerations and Patient Management
- Lithium doses should start low and increase gradually based on serum drug levels and symptoms control
- Serum drug level measurements are crucial due to narrow therapeutic range and individual variations
- Adequate renal function is essential for lithium therapy, as sodium levels affect lithium reabsorption
- Caution is needed when using lithium in patients with hepatic impairment and critical illness
- Discontinuation of lithium is necessary before surgery and may prolong the effects of anesthetics
- Common adverse effects of lithium include metallic taste, hand tremors, nausea, and weight gain
- Contraindications for lithium therapy include known sensitivity to the drug and pregnancy
- Several drugs can interact with lithium, either increasing or decreasing its effects
- Baseline studies of renal, cardiac, and thyroid status are essential before starting lithium therapy
- Serum lithium levels should be monitored regularly, with the therapeutic range being 0.5 to 1.2 mEq/L
- Lithium should be taken with food to reduce the risk of nausea and vomiting
- Patient teaching should emphasize the importance of taking lithium as directed, maintaining regular blood tests, and avoiding dehydration and excessive sweating
Mood-Stabilizing Agents: Drugs Used to Treat Bipolar Disorder
- Lithium’s mechanism of action is not fully understood, but it is believed to affect the destruction of catecholamines, inhibit neurotransmitter release, and decrease sensitivity of postsynaptic receptors.
- Lithium's action peaks in 30 minutes to 4 hours for regular forms and 4 to 6 hours for slow-release form, crossing the blood-brain barrier and placenta, and is distributed in sweat and breast milk.
- Lithium use during pregnancy is not recommended due to potential first-trimester developmental abnormalities.
- Onset of action for lithium is 5 to 14 days, and combination with antipsychotic or antidepressant agents is used to reduce symptoms in acutely manic or depressed clients.
- The half-life of lithium is 20 to 27 hours.
- About 75% of people with bipolar illness respond effectively to lithium, while the rest may have difficulty taking it due to side effects, treatment regimen, drug interactions, or medical conditions.
- Anticonvulsants like carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate, and clonazepam are used as mood stabilizers for bipolar illness, each requiring specific therapeutic level monitoring and baseline laboratory testing.
- Aripiprazole, brexpiprazole, cariprazine, ziprasidone, lurasidone, and quetiapine are adjunctive medications used alongside mood stabilizers or antidepressants to treat bipolar disorder.
- Research has shown that mood-stabilizing drugs like lithium stimulate neuronal growth and reduce brain atrophy in people with long-standing mood disorders.
- Lithium carbonate is used to treat and prevent manic episodes in bipolar disorder, proving effective in controlling mania and decreasing the frequency and intensity of manic cycles.
- Lithium is well absorbed after oral administration, with peak serum levels in 1 to 3 hours and steady-state concentrations in 5 to 7 days, and is entirely excreted by the kidneys.
- Lithium is the drug of choice for treating manic episodes of bipolar disorder and for maintenance treatment, with long-term therapy being usual practice to decrease recurrence. Gradually tapering the dose over 2 to 4 weeks delays the recurrence of symptoms.
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Description
Test your knowledge of mood-stabilizing agents used in treating bipolar disorder with this quiz. Explore the mechanisms of action, pharmacokinetics, therapeutic monitoring, and adjunctive medications for mood stabilization. Challenge yourself with questions about lithium, anticonvulsants, and adjunctive medications used in the management of bipolar illness.
