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Pmhnp AXAMS ALREADY PASSED
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HLA-B 1502 - check for prior to starting carbamazepine o asia patient, FDA required. Increased risk of SJS in pts with the allele Medication that can induce Mania: - Steroids, Antidepressants in bipolar, isoniazid, disulfiram- antabase Medication that can induce depression - Beta blockers Benz...

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  • February 1, 2024
  • 5
  • 2023/2024
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Pmhnp AXAMS ALREADY PASSED
HLA-B 1502 - ✔✔check for prior to starting carbamazepine o asia patient, FDA required. Increased risk
of SJS in pts with the allele



Medication that can induce Mania: - ✔✔Steroids, Antidepressants in bipolar, isoniazid, disulfiram-
antabase



Medication that can induce depression - ✔✔Beta blockers

Benzos

Antineoplastic drugs, accutane

Steroids

Interferon

Some retroviral drugs

Progesterone



Inhibitors - lower dose of medication - ✔✔Buproprion

Clomipramine - tricyclic

Clarithromycin

Flouroquinolones - levofloxin, cipro, moxifloxin, ofloxacin

Grapefruit jice

Ketoconazole - NIzoral, antifungal

Nefazondome MAOI

SSRI - Fluoxetine, Paroxetine



Sx of lithium toxicity - ✔✔N/V/D, altered mental status, oliguria, ataxia, coarse tremor, arrhythmias, T-
wave flattening

, EPS: Dystonia - ✔✔Can be within hours, muscle stiffness, involuntary movements and tics

Give Cogentin, Benadryl



EPS: Akathisia - ✔✔within days, figit, foot wiggle, finger tapping, rocking

Beta Blockers, propranolol



EPS: parkinsonism - ✔✔5-30 days; shuffling gait, drooling, masked facies

severe= akinesisa

Cogentin, Benadryl



EPS: Tardive Dyskinesia - ✔✔Months to years-side effects of typical antispychotics

EPS: involuntary movement abnormalities

Tardive DYSKINESIA: involuntary mouth/tongue movements

DC antipsychotic



Medication that decrease lithium - ✔✔potassium sparing diuretics, thiazide diuretics, theophylline



Medication that increase lithium - ✔✔ACE (pril) and ARBS (sartan), NSAIDS, Tetrcycline, metronidazole,
dehydration



Labs to check on lithium - ✔✔norm 0.6-1.2

CREATNINE/BUN, GFR, serum electrolytes, CBC diff, U/A, EKG - can cause t-wave flattening or inversion



NMS - Neuroleptic Malignant Syndrome Symptoms - ✔✔Hot, stiff and out of it

Hyperthermia, muscular rigidity, confusion, agitation, autonomic instability

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