Bipolar Disorder Pharmacology

Vocabulary and key clinical monitoring values for mood stabilizers, antiepileptics, and atypical antipsychotics used in bipolar disorder management.

Lithium level for acute mania

$$0.8-1.4$$

Lithium level for stabilize bipolar disorder

$$0.4-1.0$$

Lithium (Action)

Decreases excitatory neurotransmitters while increases inhibitory neurotransmitters; action not fully understood.

Lithium Renal Toxicity Nursing Implications

Monitor I/O’s, drink $2.5-3\,L/day$ $H_2O$, and monitor RFT.

Fine hand tremors (Lithium)

A side effect managed with Propranolol, possible divided doses of lithium, and monitoring for increased tremors.

Carbamazepine Action

Decreases synaptic transmission in the CNS by affecting sodium channels in neurons.

Valproate Action

Increase levels of GABA.

Lamotrigine Action

Stabilizes neuronal membranes by inhibiting sodium transport.

Thrombocytopenia Nursing Implications

Associated with Carbamazepine and Valproate; monitor platelets and s/s of bleeding.

Steven-Johnson Syndrome

A side effect of Lamotrigine; if rash occurs, hold medication and contact provider.

A-typical Antipsychotics for Bipolar Disorder

Quetiapine, Olanzapine, and Lurasidone; used to treat the depressive aspect of bipolar disorder.