Lithium, stimulants and pain

Lithium: Slowly crosses the

blood-brain barrier

Lithium: Excreted from the

kidney, 80% is reabsorbed

Lithium: Crosses the placenta

associated with congenital abnormalities

Lithium: Enters the

breast milk

Lithium: Constraindications

Allergy, renal, cardiac disease, leukemia, metabolic disorders, pregnancy, lactation

Lithium: Therapeutic Levels

0.6 - 1.2

Lithium: less than 1.5

lethargy, slurred speech, muscle weakness, nausea, vomiting

Lithium: Levels 1.5 - 2

above reactions plus ECG changes

Lithium: Levels 2 - 2.5

ataxia, clonic movements, hyperreflexia, seizures

Lithium: More than 2.5

Complex multiorgan toxicity, significant risk of death

Lithium: Drug interactions

• Haloperidol

• Carbamazepine (Tegretol)

• Thiazide Diuretic

Nursing Considerations for Antimanic Drugs

suicidal or impulsive patients with severe depression

Central Nervous System Stimulants: Indications

• Treatment attention – syndromes

• Narcolepsy

Central Nervous System Stimulants: Adverse effects

Nervousness, insomnia, dizziness, headache, blurred vision, anorexia, nausea, weight loss

Central Nervous System Stimulants: Drug interactions

• MAOI

• Guanethidine

• Tricyclic antidepressants

• Phenytoin

Central Nervous System Stimulants: Medications

Dexmethylphenidate, Vyvanse, Concentra

Pain

Sensory and emotional experience associated with actual or potential tissue damage

Drugs used to relieve pain

Narcotics abd Antimigraine Drugs

Narcotics

Opium derivatives used to treat many types of pain

Antimigraine Drugs

Reserved for the treatment of migraine headaches

Pain Receptors

• Opioid receptors

  • CNS

  • Nerves in the periphery

  • Cells in the gastrointestinal (GI) tract