Mood Stabilizers Flashcards
A physician prescribes lithium for a client diagnosed with bipolar disorder. Which of the following topics should a nurse cover when teaching the client? Select all that apply.
- Signs and symptoms of drug toxicity
- Need to consistently monitor blood levels
- Amount of time that may be needed for mood changes to occur
mood stabilizers are a lifelong therapy treatment, t or f
true - maintenance drugs
benefit of mood stabilizers
prevent depressive and manic episodes
when are antipsychotics used
severe manic episodes - calm people, allow their thoughts to be organized
several are approved for mono-therapy
antidepressants can be used in bipolar I or II
bipolar II - in addition to mood stabilizer
when using antidepressants be careful to avoid
mania
when bipolar pt. is erratic with psychosis you can use this type of drug therapy
Benzo’s
short-term drug therapy for bipolar disorder
anti-anxiety
anti-psychotics (altered thought process)
long-term drug therapy for bipolar disorder
lithium , Depakote and Tegretol (mood stabilizers)
1st drug of choice for acute mania
lithium
how is lithium excreted
through the kidney’s
lithium has a short half-life, t or f
true
when sodium is low while taking lithium what can happen
pt. can become toxic
what should we teach pt. on lithium
drink 8-8oz glasses of water
adverse effects of lithium
tremor, polyuria, goiter, mild nausea
contraindications for lithium
renal disease, diuretics (dehydration)
levels of lithium must be kept below
1.5
how often is blood drawn while taking lithium
every 2 days after started then every 2 weeks then every 1-3 months
therapeutic levels of lithium must be kept between
0.4 - 1.0
if level of lithium is above 1.0 during therapeutic level what should we do
hold the lithium
signs of lithium toxicity
flu-like symptoms that persist
can cause incoordination
when is Depakote used
rapid cycling - 4 episodes in 12 months
s/e of Depakote
weight gain - GI upset - causes skin problems - teratogenic
does Depakote have to be monitored by blood draws
yes
another drug used for rapid cycling along w/paranoia
Tegretol - good for men (helps with anger)
The presentation of Mr. Quang, a 47-year-old man, at the emergency department is blurred vision, muscle twitching, slurred speech, and severe diarrhea. He shows you, the triage nurse, a card with the following medications listed: lithium carbonate, 300 mg three times daily; clonazepam, 0.5 mg twice daily, both for sleep and agitation.What are your most appropriate actions?
Hold lithium and test his blood level
Mr. Quang is transferred from the emergency department to the intensive care psychiatric unit. You note his medical records indicate a diagnosis of bipolar I disorder. His medication orders include: discontinue the lithium carbonate and add lamotrigine on transfer to be titrated up to 100 mg per day.What is the rationale for the medication changes?
Probably toxic.
