doc 12.docx

Adam age 22, has been diagnosed with bipolar 1 disorder x 3 years. He presents with an acute episode of mania. His mother states she isn’t sure how carefully he has been taking his medicaitons: Answer: Aripiprazole IM after an oral trial establishes tolerability. Rational: Long-acting injectable ant...

Adam age 22, has been diagnosed with bipolar 1 disorder x 3 years. He presents with an acute episode of mania. His mother states she isn’t sure how carefully he has been taking his medicaitons: Answer: Aripiprazole IM after an oral trial establishes tolerability. Rational: Long-acting injectable antipsychotic meds (e.g., aripiprazole) may be appropriate for clients who struggle with medication adherence after successful oral trial. Jade, 24, is newly diagnosed with bipolar 1 with acute mania. She has IUD. What is the best medication? Lithium Rational: Lithium is teratogenic an IUD will prevent pregnancy. If the client does not want long term contraception/ decides to get pregnant you can prescribe Lurasidone as it is nonteratogenic & is monotherapy for acute mania & mixed mania. Unipolar & Bipolar depression (video from lesson) Does anyone in your family have either unipolar or bipolar depression? Need the patient’s history before they came into the office Patients tend to speak on their depression but do not talk about mania or hypomania. Get a family member’s insigh The distinction is important because treatment is different Antidepressants can make someone manic or cause someone to cycle more frequently. Antidepressant sparing strategy= use it last or never use it at all! Exhaust mood stabilizers first. Common symptoms of unipolar & bipolar depression: a depressed mood or loss of interest or pleasure in daily activities, irritability, withdrawal, and problems with sleep, eating, energy, concentration, or self-worth, thoughts of suicide or psychotic symptoms. Bipolar medications- half-life, interactions, benefits, and adverse effects    Think about the common side effects of bipolar medication class, which medication has that side effect?   Antidepressants are used cautiously in clients with bipolar disorder & never as? Monotherapy, it should be combined with a mood stabilizer to prevent onset of a hypomanic/ manic episode.