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Mechanism of Action
Side Effects
Nursing Responsibilities
Prophylaxis of manic disorder (bipolar disorder). 1.5-2 g daily may be given for the first 5-7 days.
Ataxia Tremor Muscle hyperirrita bility Slurred speech Psychomot or retardation Blurry vision
Direct client to avoid potentially dangerous situations, such as driving. Instruct the client to promptly report symptoms to the health care provider. Inform client about EPS. Advise client to rise slowly from sitting or lying to standing to prevent sudden decrease of blood pressure.
Mechanism of Action
Side Effects
Nursing Responsibilities
Block dopamine receptors in the brain; also alter dopamine release and turnover.
Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment.. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. Assess patient for signs and symptoms of dehydration.
Mechanism of Action
Side Effects
Nursing Responsibilities
Direct client to avoid potentially dangerous situations, such as driving. Instruct the client to promptly report symptoms to the health care provider. Inform client about EPS. Advise client to rise slowly from sitting or lying to standing to prevent sudden decrease of blood pressure.
Indication Dosage & Frequency Indicated for acute mania and bipolar affective disorder. 400-1600 mg/day given in 2-3 divided doses.
Mechanism of Action
Side Effects
Nursing Responsibilities
Carbamazepine stabilizes the inactivated state of Voltage-gated sodium channels, making fewer of these channels available to subsequently open. This leaves the affected cells less excitable until the drug dissociates. Carbamazepine potentiates GABA receptors made up of alpha1, beta2, gamma2 subunits. This may be relevant to its efficacy in neuropathic pain and manicdepressive illness.
Administer medication with food to minimize gastric irritation. Do not crush or chew extendedrelease tablets. If a dose is missed, take as soon as possible but not just before next dose; do not double doses. Medication should be gradually discontinued to prevent seizures. Instruct patients that fever, sore throat, mouth ulcers, easy bruising, petechiae, unusual bleeding should be reported. Advise patient not to take alcohol or other CNS depressant concurrently with this medication.
Mechanism of Action
Side Effects
Nursing Responsibilities
Treatment for acute manic or mixed episodes associated with bipolar disorder with or without psychotic features. 25 mg/kg/day
Assess for GI complaints. Assess for pain. Assess for changes in bowel. Assess for EPS. Instruct the patient to inform physician of transient intestinal cramps, increased plasma prolactin levels and EPS occur.