Mood Stabilizers

Question 1

Safety and Nx Ix for patients on Mood stabilizers

Answer 1

Increased Risk for suicide
Hyponatremia
SJS(esp w/ lamotrigine and carbamazepine)
blood dyscrasias
increased risk of birth defects
drowsiness

Question 2

Lithium Toxicity Signs

Answer 2

therapeutic range 0.6 -1.2 mEq/L

Lithium toxicity (blood levels >1.2 mEq/L) or <1.2 in elderly or debilitated but most common at 1.5 mEq/L

■ Early signs: vomiting, diarrhea

■ Over 2 mEq/L: tremors, sedation, confusion

■ Levels over 3.5 mEq/L: delirium, seizures, coma, cardiovascular collapse, death

Question 3

Patient teaching for Lithium

Answer 3

Instruct patients to report all medications, herbals, and caffeine use to physician or nurse practitioner to evaluate for drug interactions.

Encourage patients to maintain fluid intake at 2,000–3,000 mL/day and avoid activities in which excessive sweating and fluid loss are a risk because inadequate fluid intake can affect lithium levels.

Instruct patients about the importance of regular monitoring of serum lithium levels.

Blood levels should be drawn 12 hours after the last dose.

Question 4

Lithium levels

Answer 4

For acute mania: 1.0 to 1.5 mEq/L

■For maintenance: 0.6 to 1.2 mEq/L

Serum lithium levels should be monitored once or twice a week after initial treatment until dosage and serum levels are stable and then monthly during maintenance therapy. Blood samples should be drawn 12 hours after the last dose is taken.