MH meds part 10

Question 1

What is important side effect to assess for and teach pt’s about with the mood stabilizer carbamazepine (tegretol) ?

Answer 1

• leukopenia (low WBC’s)

- increases risk of infection teach pt to report fever/sore throat

Question 2

What is important side effect to assess for and teach pt’s about with the mood stabilizer valproic acid (Depakene)?

Answer 2

liver tox and jaundice (check ALTs and AST)
-low platelets and bleeding risk

-depakene = liver toxing

Question 3

What pt will have a high risk for toxicity of lithium?

Answer 3

pt taking lithium with the flu.

Question 4

What are the key points for lithium?

Answer 4

LITH:
L- levels above 1.5 = toxic
I- increase fluid and Na+ (hold med if Na+ is below 135)
T- toxicity signs, excess urination, thirst, vomiting, diarrhea, neuromuscular excitability (tremors/myoclonic jerks)
H- hold the NSAIDs (decrease renal blood flow) and diuretics

Question 5

What is one very important intervention for a pt on lithium?

Answer 5

hydration

Question 6

What are the common AE’s of atypical antipsychotics?

Answer 6

• EPS
• metabolic syndrome/ weight gain
• sedation (avoid etoh and benzo’s)
• anticholinergic effects (cant see, pee, spit, shit)
• muscle rigidity caused by NMS neuroleptic malignant syndrome (fever altered mental status) Medical emergency

Question 7

What are some common AE’s of Benzo’s?

Answer 7

• CNS depression
• anterograde amnesia
• sleep driving
• paradoxical effects
• resp. depression
• abuse
• pt teaching: dont skip doses, no alcohol, decreased ABCs, take at bedtime, no valerian root