Pharm for Bipolar Matching
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Lithium Blood Levels - Maintenance Episodes
side effects of oxcarbazepine (Trileptal)
valproate/divalproex depakene/depakote is useful for
acute mania, mixed and euphoric mania. Less effective for maintenance and bipolar depression
carbamazepine (Tegretol) dosing
400-1200mg/day (adult)
20-30mg/kg/day (child/adolescent)
baseline labs for valproate
assess for hepatic, hematological and bleeding abnormalities and pregnancy
Lithium toxicity is a medical emergency, do the following:
discontinue immediately, emesis or lavage, check labs and EKG, dialysis may be required.
Emesis is not usually recommended due to aspiration.
Lithium will not bind to activated charcoal
Signs of lithium toxicity
nausea, vomiting, diarrhea, drowsiness, tremor, muscle weakness, giddiness, ataxia, vertical nystagmus, tinnitus, diabetes insipidus, multiorgan toxicity.
Common adverse effects of lithium
tremor, weight gain, sedation, stomach upset, polyuria, thirst, edema of lower legs, hypothyroid, acne
LITHIUM
Leukocytosis, Insipidus, Tremor, Hypothyroid, Increased Urine, Mom's beware
this increases risk of rash associated with lamictal
valproate
exceeding dose recommended
exceeding dose escalation
abrupt withdrawal
Lithium dosage for the acute phase
900-2400mg/day (adult) in divided doses
SR dose 900-1800mg/day
1200-1800mg/day (child) in divided doses
start at 300mg 2-3x/day and adjust
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