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MH701 Blueprint for Exam 2 Questions and answers with 100% correct solutions | A+ Grade
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MH701 Blueprint for Exam 2 Questions and answers with 100% correct solutions | A+ Grade
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MH701 Blueprint for Exam 2 Questionsand answers with 100% correct solutions |
A+ Grade
What is Kindling Theory? ✔✔An etiologic theory of bipolar disorder that is based on the idea that a
stressful situation leads to the first bipolar episode, whether it is manic or depressive. As the disorder
progresses, further episodes may occur without any outside triggers.
What 2 neurotransmitters implicated in bipolar disorder? ✔✔Of the biogenic amines, norepinephrine
(NE) and serotonin (SE) are the two neurotransmitters most implicated in the pathophysiology of mood
disorders.
What are 3 treatment goals of bipolar? ✔✔First, the patient's SAFETY must be guaranteed.
Second, a complete diagnostic evaluation of the patient is necessary.
Third, a treatment plan that addresses not only the immediate symptoms but also the
patient's prospective well-being should be initiated.
What is the first line treatment for biploar? ✔✔Mood stabilizers are identified as first line.
,Lithium is recommended for suicidal ideation.
Risk of suicide is reduced 13-fold with long-term maintenance therapy with lithium.
Drugs approved for bipolar depression ✔✔Quetiapine (SGA), olanzapine-fluoxetine (SGA- SSRI), and
lurasidone (SGA) have all demonstrated consistent efficacy in bipolar depression and are approved
for this stage of the disorder.
What is the drug preferred for rapid cycling? ✔✔Depakote is preferred for rapid-cycling disorders
Waht medications are best for ACUTE MANIA? ✔✔**Lithium**,
**Valproate**
Carbamazepine/Oxcarbazepine, Clonazepam/Lorazepam,
Atypical Antipsychotics can be used alone or in combination to bring the patient down from the high
Can antidepressants be used alone to treat bipolar depression? ✔✔Use of antidepressants should
be avoided or used short term only and with a mood stabilizer. **Antidepressant monotherapy may
precipitate mania or induce rapid-cycling disorders between mania and depression**.
What is the first line of treatment for Acute Bipolar Depression? ✔✔Antidepressant drugs are
often enhanced by a mood stabilizer in the first-line treatment for a first or isolated episode of
bipolar depression.
,A fixed combination of ***olanzapine and fluoxetine (Symbyax)*** has been shown to be effective in
treating acute bipolar depression for an 8-week period without inducing a switch to mania or
hypomania.
Many patients who are bipolar in the depressed phase do not respond to treatment with standard
antidepressants. In these instances, lamotrigine or low-dose ziprasidone (20 to 80 mg per day) may
prove effective.
What is a tratment for bipolar after lithium and all adjunct medications have not been successful?
✔✔Electroconvulsive therapy may also be useful for patients with bipolar depression who do not
respond to lithium or other mood stabilizers and their adjuncts, particularly in cases in which intense
suicidal tendency presents as a medical emergency.
What is the treatment goal for clinicians treating bipolar patients? ✔✔Sustained euthymia
What are some S/E that lead to discontinuation of medications? ✔✔Sedation
cognitive impairment
tremor
weight gain
rash
What are the most widely used agents in the long-term treatment of patients with bipolar disorder.
, ✔✔Lithium, carbamazepine, and valproic acid, alone or in combination.
Lamotrigine has prophylactic antidepressant and, potentially, mood-stabilizing properties.
***Lamotrigine appears to have superior acute and prophylactic antidepressant properties compared
with antimanic properties.
What is a rare side effect of lamotrigine and how can it be mitigates? ✔✔Very slow increases of
lamotrigine help avoid the rare side effect of lethal rash. A dose of 200 mg per day appears to be the
average in many studies.
The incidence of severe rash (i.e., Stevens-Johnson syndrome, a toxic epidermal necrolysis) is
now thought to be approximately two in 10,000 adults and four in 10,000 children.
What is a disorder many patients develop when treated with Lithium? ✔✔Hypothyroidism
What is a disorder many patients with bipolar develop ✔✔Idiopathic thyroid dysfuction
Mood stabilzers ✔✔lithium
valproate/Depakote
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