Lithium: 1-1.5 mEq/L - okay for acute mania, Mood stabilzer, Give with food, 2 to 3 times a day, short half life, monitor plasma levels often, due to narrow therapeutic ranges, Diuretics and NSAIDs increase renal reabsorption of litium, Clients sodium level and fluid should stay the same, If the client has excessive sweating, diarrhea, or vomiting, they should see the provider, Carbamazepine: Therapuetic Range 4-12, anticonvulsant , May cause double vision - acute mania, can cause blood disorder, monitor CBC and platelet for infection, Can increase ADH, which makes the client hold onto fluids and excrete sodium - watch for hypoosmolality/ fluid volume overload/ decreased serum NA, Avoid grapefruit juice, Give at night, Used for acute mania - monitor for steven johnson's syndrome, Valproate: Therapeutic level - 50-120 mcg/mL, anticonvulsant, can cause liver and pancreas issues, monitor LFT (ALT and AST), and s/sx of jaundice, Monitor amylase, Can cause thrombocytopenia, monitor for bruising , Can cause weight gain, teach about diet and exercise, Lamotrigine: Used for maintenance - monitor for steven johnson's syndrome, May cause double / blurry vision - Maintenance, Avoid driving or activities that require concentration until the vision gets better,
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