ATI Mental Health Drugs – Flashcards
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Anxiolytic Agents - Antianxiety Medications Benzodiazepine
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Select medication - Xanax Benzo's are used short-term period of time do to the risk of the dependency.
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Benzo use
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anxiety disorders, panic disorder, and sometimes used to treat alcohol withdrawal
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alparzolam
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Xanax
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chlordiazepoxide
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Librium
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clonazepam
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Klonopin
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clorazepate
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Tranxene
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diazepam
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Valium
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halazepam
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Paxipam
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lorazepam
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Ativan
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Diazepam
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Really from anxiety and occurs rapidly
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Side effects
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sedation, drwosiness, fatiguew, dizziness, and confusion
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Adverse effects of benzo's
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Acute toxicity - oral toxicity equals drowsiness, lethargy and confusion - advise patient family to watch for OD and notify prescriber. Gastric lavage is used followed by a ministration of activated charcoal or sailing.
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For Manzel
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Is administered started to counteract the Dacian and reverse the effects of been so overdose
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Withdrawal fix
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Anxiety, insomnia, diaphoresis, tremors and my headedness. Withdrawal occurs with short-term years. After taking diazepam regulate hi doses clients are tapered over several weeks
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Nursing administration for benzo's
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-Advise client to take medication as prescribed - don't stop abruptly it may result in withdrawal symptoms , seizures or death, - admin w/caution in older adults, b/c these pt's may be more sensitive to effects of meds and be more prone to fall and confusion
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Typical Neruoleptic Agents
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Are helpful in the treatment of positive symptoms of schizophrenia and other psychotic processes.
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chlorpromazine
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Thorazine
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fluphenazine
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Prolixin
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haloperidol
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Haldol
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loxapine
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Loxitane
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mesoridazine
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Serentil
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perphenazine
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Trilafon
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thioridazine
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Mellaril
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thiothizene
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Navane
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trifluoperazine
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Stelazine
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Side effects
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-May cause drowsiness and sedation, postural hypotension, dry mouth, and blurred vision. -Watch for extrapyramidal side effects, Parkinson's syndrome - like movements, muscle rigidity, dystonia, akathisia and oculogyric crisis. -Long-term admin may result in tar dive dyskinesia
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Patient teaching
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- Caution patient to rise slowly from one position to sitting position because of hypotension. -Assess patient for abnormal involuntary movements and report to practitioner. - Provide patient with hard candy, shirtless chewing gum to help dry mouth. - Provide dietary teaching to help patient avoid or manage weight gain and diabetes associated with these other neruoleptic agents
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Atypical Neuroleptic Agents
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Treat both positive and negative symptoms of schizophrenia and other psychotic disorders
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aripiprazole
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Abilify
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clozapine
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Clozaril
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olanzapine
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Zyprexa
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quetiapine
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Seroquel
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risperidone
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Risperdal
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ziprasidone
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Geodon
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Side Effects
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- drowsiness and sedation, postural hypotension, dry mouth and blurred vision. - Watch for EPS, such as Parkinson's syndrome.
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Pt Teaching
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-Assess patient for abnormal involuntary movements and report to practitioner. -Provide patient with hard candy, sugarless chewing gum to help with dry mouth. - Provide dietary teaching to help patient a boy or man and weight gain and diabetes. -Caution patient to Risoli from a lien position to a sitting position because of hypotension.
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Extras
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When taking Clozapine teach patient to watch for and report sore throat, fever, chills and any other thought of infection immediately to prescriber. -weight gain, hyperglycemia and onset of type two diabetes have been associated with the use of atypical antipsychotic agents
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SSRI Agents - antidepressant agents
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Used for panic disorders and OCD, reducing anxiety, decreasing distress and improving overall fx. Helps w/pt that suffers from depression and anxiety
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Ciralopram
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Celexa
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esciralopram
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Lexapro
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fluoxetine
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Prozac
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fluvoxamine
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Luvox
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paroxetine
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Paxil
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sertaline
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Zoloft
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SSRI Nursing Considerations
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- can be taken once a day - not considered cardiotoxic, OD unlikely - most pt tolerate med in am, others that feel tried during day should take in pm
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Extra about SSRI's
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-sexual dysfx- anorgasmia, delayed or absent ejaculation, decreased libido - may occur w/any antidepressant but is more commonly related to SSRI agents
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Tricyclic Agents
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TCAs affects not only serotonin but also epinephrine and norepinephrine. These drugs may cause cardiac complications and severe life-threatening dysrhythmias may result from an overdose.
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amitriptyline
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Elavil
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clomipramine
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Anafranil
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desipramine
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Norpramin
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doxepin
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Sinequan
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imipramine
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Tofranil
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nortiptyline
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Pamelor
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trimipramine
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Surmontil
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Side Effects
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- Maybe more problematic in this group of meds than SSRI agents. - Many medicines cannot be taken once a day b.i.d. or TID, - dosing must be used to reach the total daily dose.
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Tetracyclic Agents
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- These agents are released the least dangerous as TCAs. -- significant sedation may occur. -Maybe given in single or divided doses.
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maprotiline
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Ludiomil
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mirtazapine
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Remeron
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Other Agents
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-Divided doses increases risk of seizures, available in the release form. -Once daily this available - dividers - sedation, -divided is less than 100 mg - sedation.
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bupropion
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Wellbutrin
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duloxetine
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Cymbalta
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nefazodone
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Serzone
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trazodone
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Desyrel
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venlafaxine
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Effexor
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MAOI Agents
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are sometimes prescribed for patients with depression that is resistant to SSRI agents, TCA's and other antidepressant agents.
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phenelzine
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Nardil
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tranylcypromine
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Parnate
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Nursing information
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a 2 week period should elapse between ending most antidepressant agent beginning MAOI. - Serious side effects of a hypertensive crisis occurs if patient taken MAOI ingest tyramine-containing foods or drink such as avocados, bananas, beer, baloney, can fix, chocolate, cheese except cottage cheese, liver, papaya products, sour cream, soy sauce, sausage. - These foods also must be avoided for three weeks after stopping treatment with an MAO I. -A washout period about four weeks must elapse when discontinuing an MAIO before starting most other antidepressant agents.
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Symptoms of hypertensive crisis
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- requires immediate treatment included headache, palpitations, visual changes, next fitness, nausea, vomiting, sweating, sensitivity to light, pupil changes, bradycardia, or tachycardia.
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Carbamazipine
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Tegretol
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Uses
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Used in treatment of bipolar disorder as well as seizure disorders.
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Nursing implications
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- Requires careful monitoring of liver enzymes and drug levels. -May cause anemia. -Because life-threatening allergic skin reactions - Steven Johnson syndrome. -Watch for rash, hold med if rash develops and notify prescriber. - May causes dizziness, drowsiness, unsteady gait. - notify prescriber if preganant
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Patient teaching
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- take drug as prescribed. -Notify prescriber if rash develops - Keep all medical appointment and blood work done as ordered. -Notify prescriber if you are pregnant. Don't breast-feed.
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Lamotrigine
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Lamictal
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Used
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Used and treatment of bipolar disorder as well as seizure disorders
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Nursing implications
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- May cause life-threatening allergic skin reactions Steven Johnson syndrome. - Watch for rash, hold med if rash develops and notify prescriber. -May cause dizziness drowsiness. -Start at low dose and titrate up slowly not more than once every 1 to 2 weeks. - Don't take it if pregnant.
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Patient teaching
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- Take exactly as prescribed. - Don't double up for missed dosages. - Swallow your tablets whole don't split, chew or crush - notify prescriber if become preggers
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Lithium
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Lithium Carbonate, Lithobid, Lithium SR
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Used for
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Treatment of bipolar disorder, occasionally used as a treatment for depression.
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Nursing implications
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- Narrow therapeutic range is 0.5 to 1.5 mEq/L. -Watch for signs for of the Lithium toxicity - nausea vomiting diarrhea changes in level of consciousness. - Maintain adequate hydration. - Monitor renal function and report abnormal findings. - Monitor serum level of lithium. -Don't change from immediate release to sustained or vice versa unless directed by prescriber, may alter levels
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Patient teaching
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- Take exactly as prescribed. -Drug must be taking regularly to achieve and maintain adequate blood level. - Don't alter salt intake. -Don't double up on dose if one is missed - Maintain adequate fluid especially in hot weather. - Avoid excessive use of caffeine beverages. -Keep follow-up appointment to have blood drawn as directed. -Report find the toxicity at once.
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Extra about lithium
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-Signs and symptoms of the Lithium toxicity include tremor, nausea, vomiting, diarrhea, and changes the level of consciousness. -It is important for patients to stay well hydrated, if the patient becomes dehydrated he or she can easily become toxic. -Greater than 1.5 mEq/L symptoms of toxicity occur
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Valproic Acid, divalproex sodium
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Depakote, Depakene
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Used
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Treatment of bipolar disorders
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Nursing implications
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-Must be monitored for their therapeutic range of 50 to 100 mcg/ml. - Metabolize in the liver, periodic liver enzymes. - May cause some sedation - May cause hair loss, if moderate to severe notify prescriber. - Report moderate to severe abdominal pain immediately to prescriber - may cause pancreatitis
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Patient teaching
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-Take drugs as prescribed. -Take them early to achieve and maintain serum blood level. -Don't double up on medication if dose is missed -Avoid driving or operating dangerous machinery until the exact effects of meds are known -. Keep follow up appointments and have a blood drawn as directed. - report abdominal pain immediately to prescriber may cause pancreatitis.
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Extras
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manic phase of bipolar disease is usually treated with Lithium and divalproex (Depakote)
