Lithium
The therapeutic range of lithium
0.6 to 0.8 mEq/L (maintenance)
- onset action slow (10-21 days)
Anticonvulsant effective for mania and rapid cycling
Valporic Acid (Depakote)
Atypical Antipsychotics block these receptors.
Dopamine and serotonin
Early signs of lithium toxicity
Nausea, vomiting, diarrhea, fine tremor
Patients of lithium must maintain stable intake of....
Sodium and fluids
The toxic range of lithium
More than 1.5
Anticonvulsant with risk of agranulocytosis and aplastic anemia.
Carbamazepine (tegretol)
Metabolic syndrome is a complication most common with this drug class.
Atypical antipsychotics
(second generation)
Severe lithium toxicity is treated with this procedure
Hemodialysis
NSAIDs and diuretics
A common side effect of lithium
tremors, nausea, polyuria
Anticonvulsant most effective in bipolar depression.
Lamotrigine (Lamictal)
A long-term EPS characterized by involuntary facial movements
Tardive Dyskinesia
Lamotrigine toxicity can cause this life-threatening rash
Steven-Johnson Syndrome
A lifestyle recommendation to reduce relapse risk
Maintaining regular sleep, exercise, and stress management
Two severe side effects of lithium
- seizures
- coma
- ataxia (off balance and coordination)
- blurred vision
- tinnitus
Anticonvulsants reduce excitability by enhancing this neurotransmitter.
GABA
An acute EPS characteruzed by painful, sustained muscle contractions
Acute Dystonia
Severe valproic acid toxicity can cause this organ failure
Hepatic Failure
Patients on antipsychotics should monitor for this cardiac complication
QT prolongation
The mechanism of action of lithium
Modification of neurotransmitters (dopamine, serotonin, norepinephrine) and stabilization of neuronal firing
Side effects of valproic acid requiring immediate medical attention
Hepatic Failure or Pancreatitis
Two atypical antipsychotics are approved for bipolar depression
Quetiapine and Lurasidone
Aplastic Anemia
Two teaching points of lamotrigine
Report rash immediately and take medication exactly as prescribed