What is the therapeutic level for carbamazepine? The therapeutic reference range of
carbamazepine is 4-12 mg/L.
The minimum toxic level is 10 mg/kg.
The toxic concentration/critical laboratory value is greater than 30-40 mg/L.
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Therapeutic carbamazepine = 4 - 12 mg/L
Minimum toxic level is 10 mg / kg
Toxic concentration is > 30 - 40 mg/L
Therapeutic indications for valproate (psychiatry)?
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, Manic phase bipolar disorder In combo with lithium or atypical
antipsychotics
Pt's for whom therapeutic drug monitoring is desirable
Which potency FGA neuroleptic agents are recommended if needed in managing
pregnant women with psychiatric illness?
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Recent studies have not demonstrated teratogenic risk associated with
high-or medium-potency neuroleptic medications;
A recent meta-analysis noted a higher risk of congenital malformations
after first-trimester exposure to low-potency neuroleptic agents.
In clinical practice, higher potency neuroleptic agents such as haloperidol
(Haldol), perphenazine (Trilafon), and trifluoperazine (Stelazine) are
recommended over the lower potency agents in managing pregnant
women with psychiatric illness. (Lecture notes)
Describe a cross taper from risperidone to olanzapine
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Taper the risperidone off over three weeks while simultaneously beginning
olanzapine at 10 mg per day
risperidone, quetiapine, and ziprazodone lack anticholinergic effects.
Abrupt transition from a DRA, olanzapine, or clozapine to one of these
agents may cause cholinergic rebound
, Psychiatric uses for carbamazepine (Tegretol)
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2nd line mood stabilizer used to treat and prevent both phases of bipolar
affective disorder.
It's analog can be used as a mood stabilizer though effectiveness has not
been confirmed in trials
What are contraindications / adverse affects for lamotrigine (Lamictal)?
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Proven allergy.
Life-Threatening / Dangerous Side Effects:
Rare serious rash (risk still rare, but may be greater in pediatric patients)
Rare multi-organ failure from Stevens-Johnson syndrome, toxic epidermal
necrolysis, or drug hypersensitivity syndrome.
Rare blood dyscrasias
Rare aseptic meningitis
Rare sudden unexplained deaths have occurred in epilepsy (unknown if
related to this drug)
Seizures with abrupt withdrawal
Rare activation of suicidal ideation and behavior (suicidality)
The presumed antipsychotic effects of the SDAs are blockade of D2 dopamine
receptors. How do the SDAs differ from older antipsychotic drugs?
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carbamazepine is 4-12 mg/L.
The minimum toxic level is 10 mg/kg.
The toxic concentration/critical laboratory value is greater than 30-40 mg/L.
Give this one a try later!
Therapeutic carbamazepine = 4 - 12 mg/L
Minimum toxic level is 10 mg / kg
Toxic concentration is > 30 - 40 mg/L
Therapeutic indications for valproate (psychiatry)?
Give this one a try later!
, Manic phase bipolar disorder In combo with lithium or atypical
antipsychotics
Pt's for whom therapeutic drug monitoring is desirable
Which potency FGA neuroleptic agents are recommended if needed in managing
pregnant women with psychiatric illness?
Give this one a try later!
Recent studies have not demonstrated teratogenic risk associated with
high-or medium-potency neuroleptic medications;
A recent meta-analysis noted a higher risk of congenital malformations
after first-trimester exposure to low-potency neuroleptic agents.
In clinical practice, higher potency neuroleptic agents such as haloperidol
(Haldol), perphenazine (Trilafon), and trifluoperazine (Stelazine) are
recommended over the lower potency agents in managing pregnant
women with psychiatric illness. (Lecture notes)
Describe a cross taper from risperidone to olanzapine
Give this one a try later!
Taper the risperidone off over three weeks while simultaneously beginning
olanzapine at 10 mg per day
risperidone, quetiapine, and ziprazodone lack anticholinergic effects.
Abrupt transition from a DRA, olanzapine, or clozapine to one of these
agents may cause cholinergic rebound
, Psychiatric uses for carbamazepine (Tegretol)
Give this one a try later!
2nd line mood stabilizer used to treat and prevent both phases of bipolar
affective disorder.
It's analog can be used as a mood stabilizer though effectiveness has not
been confirmed in trials
What are contraindications / adverse affects for lamotrigine (Lamictal)?
Give this one a try later!
Proven allergy.
Life-Threatening / Dangerous Side Effects:
Rare serious rash (risk still rare, but may be greater in pediatric patients)
Rare multi-organ failure from Stevens-Johnson syndrome, toxic epidermal
necrolysis, or drug hypersensitivity syndrome.
Rare blood dyscrasias
Rare aseptic meningitis
Rare sudden unexplained deaths have occurred in epilepsy (unknown if
related to this drug)
Seizures with abrupt withdrawal
Rare activation of suicidal ideation and behavior (suicidality)
The presumed antipsychotic effects of the SDAs are blockade of D2 dopamine
receptors. How do the SDAs differ from older antipsychotic drugs?
Give this one a try later!
