Educate client and family about the medication
Drug Classification | Drug trade/ Generic names | Actions | Side effects | Nursing implication |
LiCO3 First-line treatment for acute mania and for long-term prevention of recurrences | Lithium (Eskalith, Lithane, Lithobid, and Lithonate). | Interacts with sodium and potassium ions to stabilize electrical activity. | Fine hand tremors, polyuria, mild thirst, weight gain. Early toxic – N, V, and D, thirst, polyuria, lethargy, slurred speech, muscle weakness Advanced toxic – Course hand tremors, GI upset, confusion, sedation, incoordination Severe toxic – Ataxia, confusion, large output of dilute urine, blurred vision, clonic movements, seizures, HTN, stupor and coma. | Therapeutic range of <0.4 to 1.5mEq/L Frequent levels drawn Toxicity- withhold med and draw level Vigorously hydrate; use emetic, GI suctioning if overdose Provide supportive nursing care for bedridden patient; may need peritoneal dialysis or hemodialysis |
Anticonvulsants | Depakote (Divalproex Sodium) Tegretol (Carbamazapine) Lamictal (Lamotrigine). | Reduces the firing rate of high-frequency neurons. Is thought to reduce mood swings in patients with bipolar disorders. | Tremor, weight gain, sedation, anticholinergic side effects and rashes. | Liver panel and CBC with Depakote or Depakene. CBC, electrolyte panel with Tegretol, along with an ECG. Patients should report any rashes with Lamictal. |