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Mania Medications
Antimanics & Anticonvulsants
| Question | Answer |
|---|---|
| What medications are given to treat mania? | Antimanic Medications, Anticonvulsant Medications & some Antipsychotic Medications |
| What antimanic medication is given to treat mania? | LITHIUM |
| What does Lithium do? How does Lithium work? | Lithium is a mood stabilizer that is used to treat manic episodes of bipolar affective disorder. It acts to lower concentrations of norepinephrine and serotonin by inhibiting their release; believed to alter sodium transport in both nerve & muscle cells. |
| Do not give Lithium to a child younger than ______ years old. | 12 years old - don't give to pregnant women either. |
| It is important to monitor the client's __________ levels. | Monitor LITHIUM BLOOD LEVELS. |
| Blood samples are obtained __________ hours after dose was given; every __________ days to check lithium levels at the beginning of treatment; maintenance blood levels should be done every ___________ months. | Blood samples are obtained 12 HOURS AFTER dose was given; EVERY 2-3 DAYS to check lithium levels at the BEGINNING of treatment; MAINTENANCE blood levels should be done EVERY 1-3 MONTHS |
| Blood Levels: What is the therapeutic range or maintenance level of Lithium? | 0.5 to 1.5 mEq/L (up to 1.5 mEq/L is used for acute manic states) |
| What time of the day should Lithium be taken? | Take dose at the SAME TIME EACH DAY, preferably with MEALS OR MILK. |
| It is very important to encourage a diet containing normal amounts of _________ & ________ intake of ______ L/day. | Individuals using lithium should be advised to maintain a diet containing normal amounts of SODIUM (SALT) & FLUID INTAKE of 3 L/day & to avoid substantial changes in either. (Sodium must remain normal b/c if sodium levels are off, Lithium can be TOXIC)! |
| What should be avoided when taking Lithium? | CAFFEINE because of it's DIURETIC EFFECT |
| Taking Lithium can make it easier for you to become ____________. This can increase some of the side effects of Lithium. | Taking this medication can make it easier for you to become DEHYDRATED (especially if you have any vomiting or diarrhea, if you are outdoors in the sun, or if you exercise vigorously or sweat more than usual). |
| What s/s should be reported to the doctor because they may indicate that the the dosage may need to be temporarily reduced or discontinued? | Report POLYURIA, PROLONGED VOMITING, DIARRHEA OR FEVER to physician (may need to temporarily reduce dosage or discontinue use). |
| Blood Levels: What is considered to be TOXIC SERUM LITHIUM LEVELS? | Toxic serum lithium level is greater than 2.0 mEq/L. Levels of 2.0 to 2.5 mEq/L are considered LIFE- THREATENING! |
| What clients are at high risk for developing Lithium Toxicity? | Postoperative, dehydrated, HYPERthyroid, those with renal disease or those taking diuretics. |
| What are s/s of Lithium Toxicity? | 1)persistent diarrhea 2)vomiting or severe nausea 3)slurred speech 4)hand tremors 5)frequent muscle twitching 6)blurred vision 7)unsteady gait/difficulty walking 7)marked dizziness 8)irregular heart beat |
| Management of Lithium Toxicity may include possible _______________. | possible DIALYSIS (pt may also receive activated charcoal, IV fluids, nausea medication; gastric lavage [tube through mouth into stomach] if recently swallowed large amts of lithium to remove pills before being absorbed in the stomach) |
| Long-term Lithium use may cause __________. | Long-term use may cause GOITER; may be associated with HYPOthyroidism. |
| The nurse should TEACH the client taking Lithium the following: | 1)s/s of lithium toxicity 2)importance of frequent blood tests to check lithium levels 3)importance of taking dose at same time each day, preferably with meals or milk 4)keep food, fluid & exercise levels constant - if changed, lithium levels change |
| What are the 2 main anticonvulsants that are used in the treatment of mania? | 1)carbamazepine (Tegretol) 2)valporic acid (Depakote) |
| Other anticonvulsants that are being investigated for treatment of mania include: | 1)gabapentin (Neurontin) 2)lamotrigine (Lamictal) 3)oxcarbazepine (Trilecliental) |
| Anticonvulsants are mainly used for seizure disorders. How are anticonvulsants used in the treatment of mania? | The 2 main anticonvulsants have MOOD-STABILIZING ABILITIES and work well in manic states. They are used PRIMARILY FOR CLIENTS WHO HAVE NOT RESPONDED TO LITHIUM or WHO CANNOT TOLERATE THE SIDE EFFECTS |
| What should clients taking these medications avoid until response to the drug is established? | AVOID TASKS THAT REQUIRE ALERTNESS OR MOTOR SKILLS until response to drug is established. |
| When a client is taking the anticonvulsant carbamazepine (Tegretol) it is important to monitor _____________. What is a toxic reaction of this medication? | Monitor CBC FREQUENTLY DURING INITIATION OF THERAPY and at MONTHLY INTERVALS thereafter. TOXIC REACTIONS: BLOOD DYSCRASIAS |
| What does blood dyscrasias mean? | a generalized term that includes any kind of blood disorder or problems with the organs that make blood components. Examples include: hemophilia, sickle cell disease and some forms of anemia |
| When a client is taking the antionvulsant valproic acid (Depakote), it is important to monitor __________. | Monitor LIVER FUNCTION STUDIES |
| Anticonvulsants are toxic to the ________. | Anticonvulsants are toxic to the LIVER; therefore, LIVER FUNCTION SHOULD BE MONITORED. |
| What are some side effects of Anticonvulsants? | Drowsiness, vertigo, visual problems (spots before eyes, difficulty focusing, blurred vision), dry mouth, unsteady gait |
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