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.