Exam Week 4: NR668 / NR 668
(Latest 2024 / 2025) Psychiatric- Mental Health Capstone Practicum & Intensive | Review Questions and Answers | 100% Correct | Grade A - Chamberlain
Question:
Mood Stabilizers
Answer:
-Lithium -Lamotrigine -Carbamazepine -Valproate
Question:
Lithium
Answer:
-Mood stabilizer -Works equal or better than Valproate in Bipolar d/o 1 / 4
-Decreases SI in Bipolar d/o -Not great for rapid cycling (> 4 X per year).-not protein bound & is renally excreted • Elderly have more difficulty with this drug given their decreased renal function
-Monitor:
• CR, TSH, CBC, EKG, Li levels
-Know baseline:
• thyroid function & renal function prior to use.• Pregnancy test prior to initiation -Avoid breast feeding with use.
-Side Effects:
• Weight gain • tremor • hair loss • decreased cognition -Narrow therapeutic window • Maintenance at 0.6 - 1.0 • Early signs of toxicity over 1.5 ➣Symptoms may include tremor, N/D, blurred vision, confusion
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Question:
Lamotrigine
Answer:
-Anticonvulsant -Mood stabilizer -Helps with Bipolar Depression • is an off label use -Rare but deadly side effect of Steven-Johnson Syndrome
Question:
Carbamazepine
Answer:
-Anticonvulsant -Mood stabilizer -Induces its own metabolism -Steven-Johnson syndrome risk elevated in patients of Asian decent • Genetic screening recommended -Notable CYP3A4 inducer
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Question:
Valproate
Answer:
-Anticonvulsant -Mood stabilizer -Contraindicated in pregnancy • associated with neural tube defects
-Side effects:
• potential hepatotoxicity • pancreatitis • weight gain • dose dependent thrombocytopenia -Highly protein bound -Therapeutic range for mania= 50 - 125 mcg/mcl with a target of 80 mcg/ml
-Monitoring:
• LFTs, CBC with platelets, Serum Ammonia with MS change, serum valproate level
Question:
Antipsychotics: 1st generation
Answer:
-D2 antagonism • MOA & reason for many of the side effects -Result of D2 receptors being blocked in pathways:
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