Deck 6: Drugs Used to Treat Bipolar Disorder

Question 1

The percentage of bipolar disorder patients with a history of substance abuse is approximately:

A)20 percent.
B)55 percent.
C)80 percent.
D)less than 10 percent.

Answer 1

B

Question 2

Before excretion,lithium is:

A)metabolized to an active compound.
B)metabolized into an inactive compound.
C)converted to Na+.
D)not metabolized.

Answer 2

D

Question 3

In long-term therapy,up to 30 percent of patients taking lithium experience:

A)kidney failure.
B)heart failure.
C)ulcers.
D)obesity.

Answer 3

D

Question 4

The third-generation anticonvulsant neuromodulator lamotrigine is effective in treating:

A)acute manic episodes.
B)acute depressive episodes.
C)acute bipolar episodes.
D)All of the answers are correct.

Question 5

The psychoactive effect of lithium on normal individuals is:

A)euphoria.
B)mania.
C)depression.
D)nonexistent.

Question 6

Following administration,lithium levels can be detected up to:

A)12 hours.
B)24 hours.
C)1 to 2 days.
D)1 to 2 weeks.

Question 7

Antiepileptics include all of the following drugs,EXCEPT:

A)lithium.
B)Tegretol.
C)Depakote.
D)Lamictal.

Question 8

Pharmacodynamically,lithium and valproate have been shown to affect:

A)genes.
B)second-messenger systems.
C)cellular protective proteins.
D)All of the answers are correct.

Question 9

More than 80 percent of bipolar substance abusers self-administer:

A)alcohol.
B)nicotine.
C)cocaine.
D)marijuana.

Question 10

Long-term management of bipolar disorder is best accomplished by use of:

A)minor tranquilizers.
B)major tranquilizers.
C)mood stabilizers.
D)antipsychotics.

Question 11

Nowadays,combination therapy for bipolar disorder includes lithium and:

A)benzodiazepines.
B)antipsychotics.
C)Na+.
D)antiepileptics.

Question 12

The classic drug for treating bipolar disorder is:

A)Haldol.
B)benzodiazepines.
C)lithium.
D)Tegretol.

Question 13

When therapy is initiated,lithium continuously accumulates over the next:

A)12 hours.
B)24 hours.
C)2 days.
D)2 weeks.

Question 14

Comorbidity of bipolar disorder and substance abuse is associated with a greater risk of switching from a depressive episode to one of:

A)mania.
B)hypomania.
C)a mixed mood state.
D)All of the answers are correct.

Question 15

Long-term treatment with antidepressant/mood stabilizer combinations may:

A)improve severity of depressive symptoms.
B)worsen severity of depressive symptoms.
C)improve severity of manic symptoms.
D)worsen severity of manic symptoms.

Question 16

Tegretol is rapidly being replaced by oxcarbazepine (Trileptal)in the treatment of:

A)epilepsy.
B)bipolar disorder.
C)mania.
D)All of the answers are correct.

Question 17

The therapeutic index for lithium is ________; the antidote upon overdose is ________.

A)high; readily available
B)low; readily available
C)high; unavailable
D)low; unavailable

Question 18

The most serious side effect of valproic acid is:

A)heart disease.
B)convulsions.
C)loss of white blood cells.
D)liver damage.

Question 19

Lithium crosses the blood-brain barrier:

A)rapidly and completely.
B)slowly and incompletely.
C)rapidly but incompletely.
D)slowly but completely.

Question 20

The main toxic effect of lithium involves:

A)the kidneys.
B)the nervous system.
C)the heart.
D)All of the answers are correct.

Question 21

Anticonvulsants are ____________ effective than antidepressants in treating ____________.
B)less; major depression
C)more; borderline personality disorder
D)less; borderline personality disorder

Question 22

Lithium has a very narrow therapeutic range.

Question 23

Bipolar disorder is associated with neuronal damage.

Question 24

Bipolar II disorder is more severe than bipolar I.

Question 25

More than half of bipolar patients are substance abusers.

Question 26

The neurotransmitter most clearly linked to bipolar disorder is:

A)serotonin.
B)dopamine.
C)GABA.
D)acetylcholine.

Question 27

Valproate influences DNA to alter genetic processes.

Question 28

Lithium reduces brain damage after brain injury.

Question 29

Lithium is not metabolized before excretion.

Question 30

Of those with substance abuse,approximately 30 percent or fewer bipolar patients abuse alcohol.

Question 31

Obesity is one of the most common side effects of lithium therapy.

Question 32

Gabapentin is used to treat:

A)epilepsy.
B)pain.
C)anxiety.
D)All of the answers are correct.

Question 33

Hypomania is defined as a less severe form of bipolar disorder.

Question 34

Antidepressants decrease the likelihood of a manic switch ("flip").

Question 35

At levels less than four times the therapeutic level,lithium becomes toxic.

Question 36

The classic mood stabilizer is lithium.

Question 37

Lithium slowly crosses the blood-brain barrier.

Question 38

Lithium produces sedation and/or depression in normal individuals.

Question 39

An episode of depression is not required for a diagnosis of manic-depressive disorder.

Question 40

Topamax is useful in treating:

A)alcoholism.
B)seizures.
C)migraine headaches.
D)All of the answers are correct.

Question 41

The terms neuromodulator and anticonvulsant are interchangeable.

Question 42

The effectiveness of lithium is diminished by antiepileptics.

Question 43

There is no antidote to lithium.

Question 44

Drugs that increase acetylcholine levels produce symptoms reminiscent of mania.

Question 45

As a class,the anticonvulsants are associated with increased risk of suicide.

Question 46

The antiepileptic valproate carries a black box warning concerning pancreatitis.

Question 47

Many of the antiepileptic drugs produce birth defects.

Question 48

Fewer than 30 percent of bipolar patients can be adequately controlled by lithium.

Question 49

The anticonvulsant mood stabilizers have a pronounced effect on borderline personality disorder.

Question 50

Lamictal is more effective than lithium in preventing relapse to a depressive episode.

Question 51

Other than lithium,the best drugs for treating bipolar disorder are antidepressants.

Question 52

Almost half of patients taking lithium stop against medical advice.

Question 53

Lithium,Tegretol,and Depakote are all antiepileptics.

Question 54

The drugs of choice for some forms of bipolar disorder are antiepileptics.

Question 55

Other than lithium,the best drugs for treating bipolar disorder are antiepileptics.

Question 56

The major mechanism of action of Lamictal is blockade of voltage-gated Na⁺ channels.

Question 57

Lithium is a teratogen.

Question 58

The atypical antipsychotics appear useful in treating mania.

Question 59

Recent evidence suggests that Topamax is ineffective in treating mania.

Question 60

Goiters may be associated with long-term lithium therapy.