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
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
