Lithium
Mood Stabilizer used for bipolar
1.takes 7-14 days to reach therapeutic levels
2.Antipsychotic or benzo can be used to prevent exhaustion, coronary collapse until lithium reaches therapeutic level
3.Tell patients to suck on hard candy for metallic taste
4.Theapeutic levels = 0.8-1.2
Maintenance=0.4-1.3
5.Toxicity is diarrhea, vomiting, excessive sweating
6.Hyponatremia makes it easier to develop toxicity
more in depth lithium toxicity
levels of 1.3-1.5 = fine hand tremors, n/v, diarrhea, confusion, slurred speech, ataxia, thirst, polyuria, muscle weakness
Levels 1.6-2.0 = course hand tremors, muscle hyperirritability, sedation
Levels higher then 2.0 Require gastric lavage
Coma, Blurred vision, hypotension,
nursing interventions lithium
- lithium levels should be measured 5 days after beginning therapy and after any dosage change. This should be faster for older adults
- blood levels should be drawn in the morning 8-12 hours after the last dose
- two long-term risks =hypothyroidism and impaired kidney function
- do not give to patients with heart disease, brain damage, myasthenia gravis, renal, thyroid disease, or pregnant
- dont use NSAIDS
Digoxin
- theraputic 0.5-2.0
- watch for hypokalemia
- 60, 70, 90
- Toxicity: vision changes, anorexia, fatigue, weakness, n/v
- treat overdose with activated charcoal, cholestyramine, or digibind
high potassium foods
- spinach
2. potaatoes
Phenelzine
- what is it
- side effects
- indications
- foods
- interactions
- what do you do for hypertensive crisis
- MAOI, most end in -ine
- dizziness,headache, stiff neck, n/v, insomnia/restlessness, dry mouth, sexual dysfunction, weight gain, hepatic necrosis
- atypical depression (increased sleep/appetite, anxiety)
- anything that is aged or smoked , soybeans, figs, protein supplements
- dont give with OTC cold and flu meds or demerol or other antidepressants
- Phentolamine (Regitine)
- Nifedipine
- ice packs
