Anti-manic agents

Lithium carbonate

Drug of choice for the manic phase of bipolar disorder.

dopamine transmission

Lithium carbonate appears to enhance the thyrotropin- releasing hormone- stimulated prolactin response and reduces _______ ______

0.5 to 1.4 mEq/L

Therapeutic serum level of lithium carbonate for adult is

5-7 days

Effect of Lithium Carbonate is seen _ to _ days after initial dose

• Severe neurotoxicity

• Leucopenia

Potentially Fatal adverse effect of Lithium carbonate is

cardiac defects

Should not be prescribed to pregnant women because it may result to congenital defects especially _____ _____

lithium toxicity

Serum lithium concentrations may increase in the presence of extreme vomiting, diarrhea, or perspiration, resulting in ____ ____

1.5 to 2.0 mEq/L

Lithium toxicity occurs when the serum levels exceed

mild toxicity

1.5 to 2.0 mEq/L

moderate toxicity

2.0 to 2.5 mEq/L

severe toxicity or fatally toxic

Above 2.5 mEq/L

• Withhold medicine

• Monitor serum level

• IV therapy with normal saline

• Hemodialysis for severe toxicity

Treatment for Toxicity (Lithium carbonate) WMIH

dysgeusia

A taste disorder known as _____. It is an abnormal or impaired sense of taste, or an unpleasant alteration of taste sensation. An indication of a serious illness such as kidney and liver problems or undiagnosed diabetes or certain cancers.

• Nausea

• Metallic taste

• Abdominal discomfort

• Polydipsia

• Polyuria

• Muscle weakness

• Fine hand tremors

• Fatigue

• Mild diarrhea

• Edema of the feet, hands, abdominal walls or face.

Common S/E of lithium carbonate: NMAPP MFFME

2 hours

S/E of lithium carbonate may occur as early as 2 hours after the first dose is taken

3 to 5 weeks

Do not alter the dosage or cease taking the prescribed drug. It may require ______ to be effective (Lithium carbonate)

3 liters

Drink at least _ liters of water daily when taking lithium carbonate

• Carbolith (CAN)

• Duralith (CAN)

• Eskalith

• Eskalith CR

• Lithane (CAN)

• Lithobid

• Lithonate

• Lithotabs

• PMS-Lithium Carbonate (CAN)

Examples of Lithium CDELLLLP

Anticonvulsants

• Were originally developed and marketed for treatment of seizure disorders

• Used with success to treat bipolar disorder

• Usually reserved for clients who cannot tolerate lithium or who have not responded to lithium.

• Bone marrow depression

• Hematologic toxicity

The most dangerous adverse effect of carbamazepine BH

• Carbamazepine (Tegretol)

• Valproic Acid (Depakote, Depakene)

• Gabapentin (Neurontin)

• Lamotrigine (Lamictal)

• Topiramate (Topamax)

Examples of anticonvulsants: CVGLT

Atypical antipsychotic

Acts as mood stabilizer, the FDA recently approved this drug for use in bipolar disorder.

Olanzapine (Zyprexa)

Examples of Atypical antipsychotic