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Mood Stabilisers. By the Mood S wingers Group 1. Indicators for Use of Lithium. Manic depressive Psychoses Schizoaffective illness. Adverse Effects of Lithium. Side effects of lithium include: Nausea & vomiting diarrhoea abdominal pain muscle weakness Thirst polyuria tremor

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mood stabilisers

Mood Stabilisers

By the Mood Swingers

Group 1

indicators for use of lithium
Indicators for Use of Lithium
  • Manic depressive Psychoses
  • Schizoaffective illness.
adverse effects of lithium
Adverse Effects of Lithium
  • Side effects of lithium include:
  • Nausea & vomiting
  • diarrhoea
  • abdominal pain
  • muscle weakness
  • Thirst
  • polyuria
  • tremor
  • Weight gain
  • Signs of toxicity include:
  • ataxia,
  • muscle twitching
  • coarse tremor and
  • muscle weakness.
  • This may progress to;
  • drowsiness,
  • disorientation,
  • hypertonicity,
  • hyperreflexia,
  • fasciculations,
  • convulsions and coma.
  • Dementia, focal neurological deficits or death may ensue.
contraindications precautions
Contraindications/ Precautions
  • Toxicity may develop because of:
  • excessive intake
  • dehydration and poor salt intake
  • renal impairment
  • deliberate over-dosage or
  • due to a drug-drug interaction with medications such as;
    • diuretics and
    • NSAIDs.
  • Not to prescribe during pregnancy due to side effects
nursing implications
Nursing Implications
  • Give during or after meals to decrease GI irritation
  • Monitor serum levels at least 2 weekly to stabilise manic episodes after stabilisation every month
  • Observe for decrease in manic behaviour and mood swings and drug interactions
  • Diuretics and anti inflammatory increase the effect of lithium
  • Avoid lithium toxicity check Electrolyte levels TSH T4, LFTs routinely
carbamazepine
Carbamazepine

Uses

  • For anticonvulsant medication
  • Grand mal and partial Seizures
  • Blocks certain responses in the brain
  • Trigeminal neuralgia
  • Bipolar Disorder
  • Reduces anxiety
  • irritability elation
  • Impulse control behaviour
adverse effects
Adverse Effects
  • Low WBC and Red blood cell count
  • Liver abnormalities such as jaundice
  • Thyroid abnormalities
  • Dizziness, Nausea, Vomiting, Unsteadiness
  • Increased risk of suicidal thinking and behaviours
  • photosensitivity reactions.
  • CNS: headache, tremors, confusion, restlessness, memory loss, seizures, slurred speech, muscle weakness, lack of coordination, lethargy, stupor
  • CV: bradycardia, ECG changes, arrhythmias, hypotension, peripheral circulatory collapse
  • EENT: blurred vision, tinnitus
  • GI: anorexia,, abdominal cramps or pain, diarrhoea, dry mouth, extreme thirst, metallic taste, weight gain
  • GU: polyuria, glycosuria, proteinuria, incontinence, oedema, hyponatremia
  • Hematologic: leukocytosis
  • Skin: rash, pruritus, alopecia, sweating, dryness or thinning of hair
precaution contraindications
Precaution/ Contraindications

Interacts with multiple drugs precautions should be taken when combining other medications

These include:

  • Phenytoin
  • Primidone
  • Warfarin
  • Theophylline
  • Valproic Acid
  • Erythronycin
  • Cimetidine
  • Propoxyphine
  • Calcium Channel Blockers
  • Birth control pills

Should not be used in pregnancy and breast feeding.

nursing implications1
Nursing implications
  • Take with food
  • Instruct patient to take carbamazepine around the clock, exactly as directed.
  • Advise patient not to take alcohol or other CNS depressant concurrently with this medication.
  • Apply sunscreen and wear sun smart clothing, U.V approved eye wear
  • Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or lollies may help reduce dry mouth. Saliva substitute may be used.
sodium valproate
Sodium Valproate
  • Anticonvulsant
  • Antipsychotic
  • Mania
adverse effects1
Adverse effects
  • Haematological
  • Neurological
  • Liver dysfunction
  • Hyperammonaemia
  • Pancreatitis
  • GI Upset
  • Platelet dysfunction
  • Skin reactions
  • Hair loss
  • Oedema
  • Weight gain
precaution contradictions
Precaution/ Contradictions
  • Pre existing liver dysfunction
  • Family history of
  • Severe hepatitis
  • Urea cycle disorders
  • Pregnancy
  • Impaired renal function
  • Abrupt Withdrawal
  • Diabetes
  • Thrombocytopenia
  • Platelet levels
  • Children
  • Kidney disease
  • Congenital Metabolic disorders
  • HIV
  • Organic brain disorders
nursing implications2
Nursing Implications
  • Monitor patient alertness
  • Evaluate plasma levels for toxicity
  • Baseline platelet count
  • Serum levels
  • LFT
  • UEC
  • FBC
  • Do not discontinue medication suddenly
  • Notify DR if spontaneous bleeding occurs
indicators of use for olanzapine
Indicators of use for Olanzapine

Antipsychotic

Antimanic

Mood stabiliser disabling high and low extremes of mood associated with bipolar I disorder.

is used to treat symptoms of schizophrenia

related psychoses.

Dementia

adverse effects2
Adverse effects
  • Hypertension
  • Weight gain
  • Peripheral oedema
  • Precipitate type 2 diabetes
  • Cardiovascular disease
  • Severe CNS depression
  • Lactation
  • Narrow angle glaucoma
  • Transient elevation of liver enzymes
  • Drowsiness/ dizziness
  • GI upset
  • Constipation
  • Fever
  • Weight gain
  • Joint pain
  • Tachycardia
  • Bone marrow depletion
  • Cough and pharyngitis
precautions contraindications
Precautions/Contraindications
  • Allergies to olanzapine
  • Myeloproliferative disorder
  • Lactation
  • Cardiovascular disease
  • Diabetes
  • Prostate enlargement
  • Breast cancer
  • pregnancy
  • Reacts with Other Drugs
nursing implications3
Nursing implications
  • Do not dispense more than 1 weeks supply at a time
  • Drug interaction
  • Monitor for dehydration
  • Monitor for sedation and decreased sensation
  • Urinary retention
  • Temperature
  • Hypertension
  • Take directly as prescribed
  • Take within 1 hour window of prescribed time