V.

DRUG STUDY
Name of Drug Dose/
Mechanism of Indicatio
Generic Classification Frequency/ Contraindication Side effects Nursing Precaution
action n
(brand) Route
Lithium Antimanic Oral: Thought to alter Manic None Nausea and  Advise
agent adult:300- sodium, episodes vomiting, patient to
600mg tid- potassium ion of bipolar abdominal take with
qid, slow transport across disorder. pain, food to
release:300m cell membrane in diarrhea,
g bid; may nerve and muscle blurred minimize GI
increase q 7 cells; balance vision, upset.
days by biogenic amines drymouth.  Instruct
300mg; of nor patient to
epinephrine and swallow slow
serotonin in CNS release tablet
area involve in
whole
emotional
responses without
chewing or
crushing.
 Tell patient
to maintain
adequate
fluid intake.
 Emphasis
importance
of having
regular blood
test, to help
detect and
prevent
serious
adverse
 reactions.

Carbamazepin Anticonvulsan Adults: Unclear. For Extra  Hypersensitivity to Drowsiness,  Caution

e t initially, 100 Chemically pyramida drug or TCAs fatigue, patient to
mg BID related to l side headache,
 MAO inhibitor use avoid driving
tablets or 50 tricyclic effect blurred
mg QID (oral antidepressants within past 14 days vision, and other
suspension) (TCAs).  Bone marrow diplopia, hazardous
increase by Anticonvulsant depression pharyngeal activities until
up to 200 mg action may result dryness,
 Pregnancy or he knows
per day until from reduction in nausea,
pain relief polysynaptic breastfeeding vomiting, how drug
occurs; then responses and dry mouth affects
give blocking of post- concentration
maintenance tetanic , alertness,
dosage of 200 potentiation.
and vision.
to 1200 mg
per day in  Advise
divided doses. patient to
Usua.l avoid
maintenance excessive sun
range is 400
to 800 mg per exposure and
day to wear
protective
clothing and
sunscreen.
 Encourage
patient to
drink plenty
of water.
 Monitor vital
signs and
fluid intake
 and output.
Stay alert for
fluid
retention,
renal failure,
and
cardiovascula
r
complication.

Divalproex Depakote Initially, Increases level of For extra  Hypersensitive to Ataxia,  monitor gait
750mg P.O gamma- pyramida drug or tartrazine drowsiness, and assist as
daily in aminobutyric l side weakness,
 Hepatic necessary
divided doses. acid in brain, effect fatigue,
Titrate reducing seizure impairment menstrual  provide rest
rapidly to activity  Urea cycle changes, period
desired effect disorders dyspepsia,  give with
or through nausea,
 pregnancy food
level of 50 to vomiting,
125 mcg/ml. weight gain,  establish
hair loss balanced
nutrition

Gabapentin Neurontin Initially, Unknown. For extra  hypersensitivity to Dizziness,  assist client
300mg P.O. Possesses pyramida drug hypotension, to rise slowly
as a single properties l side ataxia,
from sitting
dose on day resembling those effect coordination
1; then of other , sedation, position
600mg in two anticonvulsants, headache,  provide rest
divided doses which appear to fatigue, period
on day 2 and stabilize cell nystagmus,  give with
900mg in membranes by nausea,
three divided altering cation vomiting food
doses on day transport, there
3. Then by decreasing
 titrate excitability and
upward as suppressing
needed to seizure discharge
1800mg/day or focus.
given in three
divided doses
Lamotrigine Lamictal Target dose is Unknown. For extra  Hypersensitivity to Dizziness,  assist client
200mg P.O Thought to block pyramida drug or its hypotension, to rise slowly
daily titrated sodium channel l side ataxia,
component. from sitting
over 7 weeks membranes, effect coordination
which in turn , sedation, position
inhibits release of headache,  monitor gait
neurotransmitter weakness and assist as
s glutamate and fatigue, necessary
aspartate in menstrual
brain. changes,  provide rest
sore throat, period
flu-like  monitor
symptoms, physical
blurred or
health
double
vision,  give with
nausea, food
vomiting,  report rashes
rashes to physician

Topiramate Topamax P.O. 50- Blocks sodium For extra  Hypersensitivity to Dizziness,  assist client
200mg/day, channels, pyramida drug or its hypotension, to rise slowly
max of enhancing the l side anxiety,
components from sitting
400mg/day action gamma- effects ataxia, in
amino butyrate; coordination position
also inhibits acid , confusion,  Monitor gait
excitatory sedation, and assist as
receptors slurred necessary.
speech,
 tremor,  Orient client.
weakness,  Protect client
blurred or
from
double
vision, potential
anorexia, injury.
nausea,  Give with
vomiting food

Clonazepam Klonopin Unknown. May For extra  Hypersensitivity to Ataxia,  Advise

enhance activity pyramida drug or other fatigue, patient to
of gamma-amino l side drowsiness,
benzodiazepines avoid driving
butyric acid, an effects behavioral
inhibitory  Severe hepatic changes, and other
neurotransmitter disease depression, hazardous
in CNS.  Acute angle- dizziness, activities
palpitation,  Advise client
closure glaucoma
blurred
vision not to drink
alcohol which
may increase
drowsiness,
dizziness and
risk of seizure