Lithium in Bipolar Disorder Quiz

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Questions and Answers

Which neurotransmitters are reduced by lithium therapy?

Norepinephrine and acetylcholine

Dopamine and glutamate (correct)

GABA and serotonin

Serotonin and acetylcholine

What is the therapeutic range for lithium?

0.5-1.0 mEq/L (correct)

1.5-2.0 mEq/L

2.5-3.0 mEq/L

0.1-0.3 mEq/L

Which side effect is NOT associated with lithium therapy?

Insomnia (correct)

Metallic taste

Thirst

Weight gain

What is the drug of choice for treating acute mania?

Lithium Signup and view all the answers

In what condition should psychotic patients be put on antipsychotic drugs while waiting for lithium to take effect?

When showing signs of mania Signup and view all the answers

What is the onset of action for carbamazepine in treating mixed episodes and rapid cycling bipolar disorder?

$5-7$ days Signup and view all the answers

Why should antipsychotic medications not be used to treat dementia-related psychoses in the elderly?

They can increase the risk of mortality Signup and view all the answers

What is the mechanism of action of typical antipsychotic drugs?

Blocking dopamine receptors Signup and view all the answers

What is the indication for using atypical antipsychotic drugs?

Blocking both dopamine and serotonin receptors Signup and view all the answers

What is the initial time frame for observing effects of antipsychotic drugs?

2 days Signup and view all the answers

What neurological system do typical antipsychotic drugs depress?

Central nervous system (CNS) Signup and view all the answers

What adverse effects are associated with antipsychotic drugs due to their pharmacological activity?

Low blood pressure (hypotension) Signup and view all the answers

What is the main purpose of using Risperidone in children and adolescents?

To manage irritability and aggression associated with autistic disorders Signup and view all the answers

Which type of drugs are typically used to decrease pseudoparkinsonism symptoms, acute dystonia, and akathisia?

Anticholinergic drugs Signup and view all the answers

What class of drugs is commonly used to decrease tardive dyskinesia?

Benzodiazepines Signup and view all the answers

Which symptom is not associated with Neuroleptic Malignant Syndrome?

Constipation Signup and view all the answers

What is the recommended action if a patient develops Neuroleptic Malignant Syndrome?

Immediately stop antipsychotic medication Signup and view all the answers

Which drug class is most frequently used for preventing anxiety without causing much sedation?

Benzodiazepines Signup and view all the answers

Study Notes

Mood Stabilizers

Lithium is the drug of choice for treating acute mania and as prophylaxis for both manic and depressive episodes in bipolar disorder.
Lithium reduces excitatory neurotransmission (dopamine and glutamate) and increases inhibitory neurotransmission (GABA), having a calming effect.
Therapeutic range of lithium is 0.4-1.3 mEq/L.
Side effects of lithium include dry mouth, thirst, increased urination, water and sodium loss, weight gain, and bloatedness.
Patients taking lithium should monitor blood levels regularly, drink 2-3 liters of fluid a day, and eat well with normal sodium intake.
Lithium takes about 2-3 weeks to show effectiveness.

Other Mood Stabilizers

Carbamazepine is used to treat mixed episodes and rapid-cycling bipolar disorder, with an onset of action of 5-7 days.
Valproic acid is an anticonvulsant that is useful in treating mixed manic episodes and rapid-cycling bipolar disorder.

Antipsychotic Drugs

Antipsychotic drugs are dopamine receptor blockers, used to treat disorders that involve thought processes.
Indications for antipsychotic drugs include schizophrenia, bipolar disorder (manic phase), delusional disorders, depressive psychoses, and drug-induced psychoses.
Initial effects of antipsychotic drugs may be seen in 2 days, but 2-4 weeks are needed for full effect.
Contraindications for antipsychotic drugs include dementia-related psychoses in the elderly, as they can increase the risk of mortality.

Typical Antipsychotic Drugs

Typical antipsychotic drugs block dopamine receptors, preventing the stimulation of postsynaptic neurons by dopamine.
They also have anticholinergic, antihistamine, and alpha-adrenergic blocking effects.

Atypical Antipsychotic Drugs

Atypical antipsychotic drugs block both dopamine and serotonin receptors.
Risperidone is used frequently to treat irritability and aggression associated with autistic disorders in children and adolescents.

Extrapyramidal Motor Symptoms

Extrapyramidal motor symptoms are movement disorders most commonly caused by exposure to dopamine-blocking medications such as antipsychotics.
Anticholinergic drugs help decrease pseudoparkinsonism symptoms, acute dystonia, and akathisia.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome is a rare but potentially fatal condition.
Symptoms include muscle rigidity, sudden high fever, altered mental status, blood pressure fluctuations, tachycardia, dysrhythmias, seizures, acute renal failure, respiratory failure, and coma.
Treatment involves immediately stopping antipsychotic medication, using Dantrolene as a muscle relaxant, and Bromocriptine as a dopamine receptor agonist to relieve CNS toxicity.

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Description

Test your knowledge on the use of lithium in the treatment of bipolar disorder. Learn about its effects on neurotransmission, therapeutic range, and potential side effects including dry mouth, thirst, and weight gain.