What is lithium?
- -Treats bipolar disorder
- -competes with Sodium
- -Maintenance dose is 900-1200
- -Therapeutic drug levels: 0.6-1.2
- SE: Dose dependent, hand tremot, metallic taste, Nephrogenic diabetes insipidus
- -Contraindicated in pregnancy, renal and cardio issues
- -Interactions: diurectics, hypertension, NSAIDS, low sodium, decreases with caffeine alcohol.
When should a nurse check blood levels of lithium?
-In the morning before first dose
What are Valproates?
- -Divalproex (Depakote)
- -Increase inhibitory role of GABA, suppression of sodium and calcium influx
- -Rapid onset
- SE: transient hair loss, weight gain, tremores, GI upset, and dose related thrombocytopenia
- -Therapetuic serum levels are from 50-115 mcg/ml
What is carbamazepine (Tegretol)?
- -Good for rapid cycling bipolar
- -Therapeutic level: 4-12 mcg/ml
- SE: nausea, anorexia, and occasional vomiting, sedation, drowsiness, agranulocytosis
- -Do not give with SSRIs
What is Lamotrigine (Lamictal)?
- -Treats bipolar disorder and bipolar depression
- -Manipulates GABA system and glutamate
- -Stevens-Johnson syndrome is a serious potentially fatal skin rush
What is Oxcarbazepine (Trileptal)?
- -Drug does not cause some of the more serious adverse reactions
What is Gabapentin (Neurontin)?
- -Adjunctive agent
- -Similar to lamotrigine
What is topiramate (topamax)?
- -Increases GABA, blocks voltage gated sodium and calcium and inhibits glutamute. -Many patients reprot weight loss with this drug
Which atypical antipsychotic is not effective for treating mania?