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Two mood stabilizers used:
Lithium
Anticonvulsants
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Two first line medications most often used for long term tx of bipolar are:
- lithium
- valproic acid (depakote)
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Natural salt in body
Lithium
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Lithium normalizes the reuptake of certain neurotransmitters such as serotonin, norepi, acetylcholine and dopamine.
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Valporic acid and topiramate increase ____?
GABA
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Valporic acid and Carbamazepine stabilize mood by inhibiting the _______ process.
Kindeling
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Lithium levels should be:
about 1.0
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Lithium level that is toxic:
1.5 or greater
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Check lithium level every 2-3 days, then weekly, then monthly.
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- Fine hand tremor
- n/d
- anorexia
- polydipsia, polyuria
- metallic taste
- fatigue
- weight gain
These are what kind of side effects of lithium?
REGULAR side effects.
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- Severe diarrhea and vomiting
- Drowsiness
- Muscle weakness
- Lack of coordination
- Renal failure
- Coma and death
These are what kind of side effects of lithium?
Toxic effects
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Effects of anticonvulsants:
- - drownisess
- - sedation
- - dry mouth
- - blurred vision
- - rashes
- - hand tremor
- - liver failure
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Fine tremors that turn into coarse tremors.
Mild GI upset progressing into persistent upset.
Lithium toxicity
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-Slurred speech
-Muscle weakness to mental confusion
-Muscle hyperirritability
-Poor Coordination
-EEG changes
Lithium toxicity
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SEVERE Lithium Toxicity:
- Decreasing LOC to stupor to coma
- Seizures
- Severe hypotension
- Severe polyuria
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Process by which seizure activity in a specific area of the brain is initially stimulated by reaching a threshold of the cumulative effects of stress, low amounts of electric impulses or chemicals such as cocaine that sensitize nerve cells and pathways.
Kindling effect
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Kindling effect (raises or lowers) threshold, you need (more or less) of a stimulus to have a result.
raises
more
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