Ch. 23 - Meds for bipolar disorders Flashcards
during a manic episode, lithium level should be what
0.8-1.4
antiepileptic meds are particularly useful for cilents who have what two disorders
mixed mania
rapid-cycling bipolar
antiepileptic meds for bipolar include
5
COLTV - carbs, ox, lamo, top, val
- carbamazepine
- oxcarbazepine
- lamotrigine
- topiramate
- valproic acid
lithium GI sx and interventions
nausea, diarrhea, abd pain
NI: educate that GI distress is transiet; take with meals or milk
valproate - monitor what
AST/ALT and LDH due to risk for hepatotoxicity
lithium - tinnitis
severe toxicity sign
when should you administer antiepileptic meds
at bedtime
carbamazepine is contraindicated in who
pt with bone marrow suppression or bleeding disorders
lithium - decreased blood sodium levels
lithium excretion is decreased (increase of lithium in the blood)
why give antipsychotics of bipolar
3
- promote sleep
- decrease anxiety and agitation
- demonstrate mood stabilizing properties
if pt is taking lithium, they should seek medical attention if the experience what three things
diarrhea
vomiting
excessive sweating
anxiolytics for acute mania
2
clonazepam
lorazepam
lithium therapeutic use in bipolar
3
- controls episodes of acute mania
- helps to prevent return of mania or depression
- decreases incidence of suicie
aminophylline use
can be used to treat severe toxicity of lithium, levels greater than 1.5
lithium maintenance level
0.6-1.2
polyuria is to
lithium toxicity
blood dyscrasias (leukopenia, anemia, thrombocytopenia) is SE of
anti epileptics
antiepileptic meds have a minimal effect on ___ function
cognitive
lamotrigine side effects
5
double or blurred vision dizziness headache nausea vomiting
diuretics (furosemide) and lithium
contraindicated together due to risk for toxicity
lithium effect in the brain
serotonin receptor blockade
lithium with NSAIDs
increases renal reabsorption of lithium (use aspirin instead)
when can pt feel benefits from lithium
5-7 days but may take 2-3 weeks
