Bipolar medications Flashcards
(23 cards)
lithium levels when treating mania
Acute mania blood levels: 1 to 1.5 mEq/L
Maintenance: 0.6 to 1.2 mEq/L
Monthly lab work after stabilization
things to avoid when taking lithium
excessive sweating
driving and heavy machinery if dizzy or drowsy
excessive amounts of sodium or caffeine
avoid alcohol
medication interaction
adverse effects of lithium
- Drowsiness, dizziness, headache
- Dry mouth, thirst
- GI upset, N/V
- Fine hand tremors
- Hypotension, arrhythmias, pulse irregularities
- Polyuria, dehydration
- Weight gain
early signs of lithium toxicity at 1.5
N/V/D
thirst
polyuria
lethargy
slurred speech
fine tremor
muscle weakness
blurred vision
advanced sign of lithium toxicity at 1.5-2
Coarse hand tremor
GI upset
mental confusion
muscle hyperirritability
EEG changes
sedation
incoordination
severe lithium toxicity signs at 2-2.5
Ataxia,
giddiness
serious EEG changes
blurred vision
clonic movements
large output of dilute urine
seizures
stupor
severe hypotension
coma
death
symptoms of lithium toxicity when above 2.5
convulsions
oliguria
death
Anticonvulsant Medication—mood stabilizer examples
Carbamazepine (Tegretol)-D category
Oxcarbazepine (Trileptal)-C
Valproic acid (Depakote)-D
Lamotrigine (Lamictal)-C category
Topiramate (Topamax)-D
Clonazepam (Klonopin)-D
adverse effects of anticonvulsant medication examples
- N/V
- Drowsiness, dizziness
- Blood dyscrasias
- Prolonged bleeding time-Valporic acid
- Risk of severe rash—Steven Johnson—Lamictal
- Decreased efficacy with oral contraceptives—Topamax
nursing priorities for admin of anticonvulsant mood stabilizers
Monitor blood levels
Avoid driving and heavy machinery if dizzy or drowsy, alcohol, ID card
Taper drug
what to report with anticonvulsant mood disorders
skin rash
unusual bleeding
spontaneous bruising
sore throat
fever
malaise
dark urine
yellow skin or eyes
calcium channel blocker example
Verapamil (Calan)-C category
adverse effects of CCBs
- Drowsiness, dizziness
- Hypotension, bradycardia
- Nausea
- Constipation
what to report with CCB admin
irregular heartbeat
SOB
edema of hands and feet
pronounced dizziness
chest pain
profound mood swings
severe and persistent headaches
atypical antipsychotic med examples
Aripiprazole (Abilify): Atypical antipsychotic—approved for MDD, bipolar—may smoke out DM, somnolence
* Black box: Dementia, SI
* Slow titration of doses
Olanzapine (Zyprexa)—weight gain
Olanzapine and fluoxetine (Symbyax)
Quetiapine (Seroquel)—drowsiness
Risperidone (Risperdal)—breast changes
Ziprasidone (Geodon)
Asenapine (Saphris)–drowsiness
Chlopromazine—only typical antipsychotic
precautions for antipsychotics
Avoid driving and heavy machinery if dizzy or drowsy, alcohol
Rise slowly, use sunscreen, ID card, smoking should be reported
adverse effects of antipsychotics
- Drowsiness, dizziness
- Dry mouth, constipation
- Increased appetite, weight gain
- ECG changes
- Extrapyramidal symptoms
- Hyperglycemia and diabetes
what to report with antipsychotics
sore throat
fever
malaise
unusual bleeding
easy bruising
persistent N/V
severe headache
rapid heart rate
difficulty urinating
muscle twitching
tremors
dark colored urine
excessive urine-thirst-or hunger
pale stools
yellow skin or eyes
muscular incoordination
skin rash
symptoms to tell provider when taking lithium
N/V/D
antipsychotic having weight gain
olanzapine (zyprexa)
antipsychotic showing drowsiness
quetiapine (seroquel)
asenapine (saphris)
antipsychotic showing breast changes
risperidone (risperdal)
only typical antipsychotic
chlopromazine
