pharmacology 4 Flashcards
Bipolar disorder is characterised
by changes of mood and affect from very
low (depressed state) to very high (manic state), with not every person
experiencing both extremes
Depression phase is frequently more difficult to treat
than mania
The depressed state will usually be treated
with antidepressants,
manic states
with a mixture of ‘mood stabilising’ medications and
antipsychotics
The most common medications for mood stabilisation are:
Lithium carbonate (mania, but routinely used for all types)
• Sodium valproate (mania)
• Carbamazepine (mania)
• Lamotrigine (mania and depression – requires special monitoring)
• Topiramate (ok for depressed phase and for reducing weight)
• Olanzapine (atypical antipsychotic with a benzo-like effect)
Lithium carbonate
is a naturally occurring salt. It has been in use
since 1949, and despite more modern medications, remains the
medication of choice for treating bipolar disorder
Common adverse reactions lithium
weight gain sedation fine tremor
thirst polyuria
gastrointestinal upset
Lithium carbonate treatment requires blood monitoring
- the
difference between therapeutic levels and toxicity is marginal,
especially at high doses
Toxicity leads to nervous system and renal damage
• Long term use may lead to goiter or a hypothyroid state (40-50% of
pts) – monitor thyroid function
Therapeutic levels for lithium carbonate:
- 0.6 – 1.2 mmol/L for acute mania
* 0.6 – 0.8 mmol/L for maintenance
• Toxic
• >2.0 mmol/L
• toxicity may develop at lower levels, particularly in
older clients)
- Lithium
• Contraindications
- Cardiac disease
- Renal disease
- Pregnancy & lactation
- Dehydration/sodium depletion
- Brain damage
anxiety
disorders
Benzodiazepines (sedative hypnotics) and
antidepressants are both routinely used to treat
Common anxiolytic medications include:
alprazolam diazepam
oxazepam
Adverse effects include: anxiolytic medications
drowsiness, dizziness, impaired motor coordination
• visual disturbances, agitation
• dependence & decreased effectiveness over time
Managing Meds – Nursing Responsibilities
al Medications Depot Medications
Regardless of the type or purpose of medication, nurses who
administer medications have a responsibility to understand the
actions, monitoring, and any potential adverse effects.
nurse must have or obtain prior
to asking a patient to ‘comply’ with treatment
Drug interactions, client allergies, monitoring regimes, and
other ethico-legal aspects of medication management are all
examples
key factors when aiming for patient
safety and therapeutic outcomes
Assessing for need and efficacy, and documenting and
communicating results, are key factors when aiming for patient
safety and therapeutic outcomes
Standard 7: Treatment and support
To meet the needs, goals and
aspirations of people and their families and carers, mental health practitioners
deliver quality, evidence-informed health and social interventions.
