Bipolar medications Flashcards

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1
Q

lithium levels when treating mania

A

Acute mania blood levels: 1 to 1.5 mEq/L
Maintenance: 0.6 to 1.2 mEq/L
Monthly lab work after stabilization

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2
Q

things to avoid when taking lithium

A

excessive sweating
driving and heavy machinery if dizzy or drowsy
excessive amounts of sodium or caffeine
avoid alcohol
medication interaction

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3
Q

adverse effects of lithium

A
  • Drowsiness, dizziness, headache
  • Dry mouth, thirst
  • GI upset, N/V
  • Fine hand tremors
  • Hypotension, arrhythmias, pulse irregularities
  • Polyuria, dehydration
  • Weight gain
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4
Q

early signs of lithium toxicity at 1.5

A

N/V/D
thirst
polyuria
lethargy
slurred speech
fine tremor
muscle weakness
blurred vision

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5
Q

advanced sign of lithium toxicity at 1.5-2

A

Coarse hand tremor
GI upset
mental confusion
muscle hyperirritability
EEG changes
sedation
incoordination

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6
Q

severe lithium toxicity signs at 2-2.5

A

Ataxia,
giddiness
serious EEG changes
blurred vision
clonic movements
large output of dilute urine
seizures
stupor
severe hypotension
coma
death

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7
Q

symptoms of lithium toxicity when above 2.5

A

convulsions
oliguria
death

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8
Q

Anticonvulsant Medication—mood stabilizer examples

A

Carbamazepine (Tegretol)-D category
Oxcarbazepine (Trileptal)-C
Valproic acid (Depakote)-D
Lamotrigine (Lamictal)-C category
Topiramate (Topamax)-D
Clonazepam (Klonopin)-D

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9
Q

adverse effects of anticonvulsant medication examples

A
  • N/V
  • Drowsiness, dizziness
  • Blood dyscrasias
  • Prolonged bleeding time-Valporic acid
  • Risk of severe rash—Steven Johnson—Lamictal
  • Decreased efficacy with oral contraceptives—Topamax
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10
Q

nursing priorities for admin of anticonvulsant mood stabilizers

A

Monitor blood levels

Avoid driving and heavy machinery if dizzy or drowsy, alcohol, ID card
Taper drug

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11
Q

what to report with anticonvulsant mood disorders

A

skin rash
unusual bleeding
spontaneous bruising
sore throat
fever
malaise
dark urine
yellow skin or eyes

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12
Q

calcium channel blocker example

A

Verapamil (Calan)-C category

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13
Q

adverse effects of CCBs

A
  • Drowsiness, dizziness
  • Hypotension, bradycardia
  • Nausea
  • Constipation
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14
Q

what to report with CCB admin

A

irregular heartbeat
SOB
edema of hands and feet
pronounced dizziness
chest pain
profound mood swings
severe and persistent headaches

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15
Q

atypical antipsychotic med examples

A

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

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16
Q

precautions for antipsychotics

A

Avoid driving and heavy machinery if dizzy or drowsy, alcohol
Rise slowly, use sunscreen, ID card, smoking should be reported

17
Q

adverse effects of antipsychotics

A
  • Drowsiness, dizziness
  • Dry mouth, constipation
  • Increased appetite, weight gain
  • ECG changes
  • Extrapyramidal symptoms
  • Hyperglycemia and diabetes
18
Q

what to report with antipsychotics

A

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

19
Q

symptoms to tell provider when taking lithium

A

N/V/D

20
Q

antipsychotic having weight gain

A

olanzapine (zyprexa)

21
Q

antipsychotic showing drowsiness

A

quetiapine (seroquel)
asenapine (saphris)

22
Q

antipsychotic showing breast changes

A

risperidone (risperdal)

23
Q

only typical antipsychotic

A

chlopromazine