What are the side effects of lithium (therapeutic level)? Right Ans - GI
effects, tremors, polyuria, renal toxicity, goiter, hypothyroidism, teratogenesis.
What will happen to side effects when one has a toxic level of lithium?
Right Ans - the effects will be much worse and possibly life threatening i.e.
tremor that becomes larger with muscle incoordination
When should we complete blood testing with use of lithium? Right Ans -
early in therapy- every 2-3 days, until a therapeutic dose has been established,
then long term-every 3 to 6 months
Therapeutic level of lithium Right Ans - 0.8-1.4 mEq/L
Toxic level of lithium Right Ans - greater than 1.5 mEq/L
When can we start to see side effects of lithium? Right Ans - when the drug
is at a therapeutic level. they are expected.
What medications can we use to treat the cyclic effects of bipolar (mood-
depression- psychosis)? Right Ans - mood stabilizer (lithium)= control
mood
antidepressant (SSRI,TCA,MAOI)= control depression
antipsychotic (Ist/2nd generation)= control the psychosis
How does a benzodiazepine help with ETOH withdrawal? Right Ans - it will
decrease the withdrawal manifestations and intensity, while making one
sleepy and having CNS depression. plus, it is easy to give IM and will work
quickly.
What is a popular benzodiazepine that is used to treat anxiety? Right Ans -
alprazolam (think A-anxiety)
How does alprazolam work to reduce anxiety? Right Ans - it inhibits GABA
in the CNS, depressing the CNS.
, What are the side effects of alprazolam use? Right Ans - a. CNS depression,
anterograde amnesia (patient cannot remember much), sleep driving (not
safe), paradoxical effects (still anxious, stays up, rowdy), respiratory
depression.
What drugs does alprazolam interact with? Right Ans - CNS depressant
medications (additive effects), ETOH
What are various treatments and drugs used to treat anxiety patients?
Right Ans - benzo's (pam/lam), atypical anxiolytic buspirone, SSRIs
paroxetine/fluoxetine, TCAs, MAOIs, trazodone.
Explain what a sedative hypnotic does Right Ans - cause the patient to have
sedation, sleepiness, CNS depression, anterograde amnesia (patient cannot
remember much), sleep driving (not safe),respiratory depression
What things should we teach the patient using a drug to treat anxiety?
Right Ans - drug should be tapered only by the HCP, not patient
no ETOH use
what withdrawal effects may look like
What does anxiety medication PO withdraw look like? Right Ans -
drowsiness, lethargy, confusion
What does anxiety medication IV withdraw look like? Right Ans -
hypotension, respiratory arrest, cardiac arrest.
Explain what methylphenidate does Right Ans - increases attention and
focus in children (NOTHING DEALING W/ BEHAVIORS)
Other effects of methylphenidate use in children Right Ans - decreased
appetite
insomnia if given late in the day
What things should we always do when giving methylphenidate to a child
with ADHD? Right Ans - ALWAYS: give the drug in the morning, after
breakfast, and give the last dose before 4pm, or else the child will not sleep at
night
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