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ESKALITH 450mg Bipolar Disorder; Lithium carbonate Patients with severe Neuromuscular: >Patients
BID Depression; is indicated in the cardiovascular or tremor, muscle receiving such
Lithium Mania treatment of manic renal disease and hyperirritability,hyperto combined therapy
Carbonate episodes of manic- those with evidence nicity, ataxia, choreo- should have
depressive illness. of severe athetotic movements, serum lithium
Maintenance debilitation or hyperactive deep levels monitored
therapy prevents or dehydration, sodium tendon reflex, closely and the
diminishes the depletion, brain extrapyramidal lithium dosage
intensity of damage. Conditions symptoms including adjusted if
subsequent requiring low acute dystonia, necessary.
episodes in those sodium intake. cogwheel rigidity,
manic-depressive blackout spells, >It is essential for
patients with a epileptiform seizures, the patient to
history of mania. slurred speech, maintain a normal
dizziness, vertigo, diet, including
downbeat nystagmus, salt, and an
incontinence of urine or adequate fluid
feces, somnolence, intake (2500-3000
psychomotor ml.) at least
retardation, during the initial
restlessness, confusion, stabilization
stupor, coma, tongue period.
movements, tics,
tinnitus, hallucinations, >Avoid large
poor memory, slowed amounts of
intellectual functioning, caffeine-
startled response, containing foods
worsening of organic and beverages,
brain syndromes such as coffee,
tea, cocoa, cola
Cardiovascular: cardia drinks, and
c arrhythmia, chocolate. Avoid
hypotension, peripheral excessive
circulatory collapse, sweating caused
bradycardia, sinus node by hot weather,
dysfunction with severe hot baths, saunas,
bradycardia (which may or exercising.
result in syncope)
Gastrointestinal: anor
exia, nausea, vomiting,
diarrhea, gastritis,
salivary gland swelling,
abdominal pain,
excessive salivation,
flatulence, indigestion
Genitourinary: glycos
uria, decreased
creatinine clearance,
albuminuria, oliguria,
and symptoms of
nephrogenic diabetes
insipidus including
polyuria, thirst, and
polydipsia
Dermatologic: drying
and thinning of hair,
alopecia, anesthesia of
skin, acne, chronic
folliculitis, xerosis cutis,
psoriasis or its
exacerbation,
generalized pruritus
with of without rash,
cutaneous ulcers,
angioedema
Autonomic: blurred
vision, dry mouth,
impotence/sexual
dysfunction
THORAZIN 200mg Antipsychotic - The management Comatose or Automatic Nervous >Inform physician
Antiemetic of psychotic depressed states System: if antihistamines;
Chlorpromazi disorders including due to CNS dry mouth, blurred lithium (Eskalith,
ne manifestations of depressants; blood vision, constipation, Lithobid);
manic depressive dyscrasias; bone ileus, nasal stuffiness, medications for
illness, manic marrow depression; photophobia. Syncope depression,
phase and severe liver damage. and impaired Parkinson's
behavioral Hypersensitivity to temperature regulation disease, seizures,
problems in chlorpromazine. have also occurred. hay fever,
children; nausea Cross allergenicity allergies, or colds;
and vomiting due with other Cardiovascular: muscle relaxants;
to stimulation of phenothiazines may Its effects on the ECG narcotics (pain
the chemoreceptor occur. include prolongation of medication);
trigger zone. the PR and QT intervals, sedatives;
Should be avoided blunting of the T wave sleeping pills; and
in children or and depression of the S- vitamins.
adolescents with T segment. Ventricular
signs or symptoms arrythmia and sudden >You should know
suggestive of Reye's death have occurred that this drug
Syndrome. Its rarely. may make you
antiemetic effect drowsy. Do not
may mask the signs Orthostatic drive a car or
and its CNS effect hypotension,tachycardi operate
may be confused a, fainting and dizziness machinery until
with the signs of have also occurred. you know how
Reye's Syndrome or Hypotension can also this drug affects
other occur after oral you.
encephalopathies. administration.
>Remember that
CNS: alcohol can add to
Extrapyramidal the drowsiness
reactions, including caused by this
pseudoparkinsonism drug.
(with motor retardation,
rigidity, mask like >Plan to avoid
facies, pill rolling and unnecessary or
other tremors, drooling, prolonged
shuffling gait, etc.); exposure to
dystonic reactions sunlight and to
(including periroral wear protective
spasms, trismus, tics, clothing,
torticollis, oculogyric sunglasses, and
crises, protrusion of the sunscreen.
tongue, difficulty Chlorpromazine
swallowing, carpopedal may make your
spasm, opisthotonos of skin sensitive to
the back muscles); and sunlight.
akathisia,tardive
dyskinesia
Dermatologic:
Itching, rash,
hypertrophic papillae of
the tongue,
angioneurotic edema,
erythema, allergic
purpura, exfoliative
dermatitis,
photosensitivity.
Endocrine:
Increased prolactin
secretion;
gynecomastia,
galactorrhea,
mastalgia, altered
libido, menstrual
irregularities, weight
gain, alterations in
glucose tolerance and
false positive
pregnancy tests have
occurred.
Gastrointestinal:
Nausea, vomiting,
increase or decrease in
appetite, gastric
irritation, constipation,
paralytic ileus, rarely
diarrhea. Dry mouth.
Genitourinary:
Urinary retention,
priapism, inhibition of
ejaculation.
Hematologic:
Agranulocytosis,
leukopenia,
granulocytopenia,
eosinophilia,
thrombocytopenia,
anemia, aplastic
anemia, pancytopenia,
agranulocytosis
Neuroleptic
Malignant Syndrome
Hyperglycemia: may
be extreme and
associated with
ketoacidosis,
hyperosmolar coma, or
death. Use with caution
in patients with
diabetes or other
disorders of glucose
regulation; monitor for
worsening of glucose
control.
Neuroleptic
malignant syndrome
(NMS): monitor for
mental status changes,
fever, muscle rigidity
and/or autonomic
instability.
• Orthostatic
hypotension:
hypotensive episodes
(cerebrovascular
disease, cardiovascular
disease, hypovolemia,
or concurrent
medication use which
may predispose to
hypotension/bradycardi
a).
Sedation: CNS
depression is a feature;
patients must be
cautioned about
performing tasks which
require mental
alertness (eg, operating
machinery or driving).
Use with caution in
patients receiving
general anesthesia.
Temperature
regulation: Impaired
core body temperature
regulation may occur;
caution with strenuous
exercise, heat
exposure, dehydration
Thromboembolism:
Rare cases of
thromboembolism,
including pulmonary
embolism and stroke
resulting in fatalities,
have been associated
with clozapine in
patients with
cardiovascular disease.
Weight gain:
Significant weight gain
has been observed with
antipsychotic therapy;
incidence varies with
product. Monitor waist
circumference and BMI.