mood stabilizing agents (2)

8/2/2019 Mood Stabilizing Agents (2)

1/21

Mood Stabilizing Agents


2/21

By :-Basma mustafa

abukhadeir


3/21

Mood Stabilizing AgentsMood stabilizers are medicines used in the treatment ofbipolar disorder, where a persons mood changes from

a depressed feeling to a high manic feeling,Thesedrugs can help reduce mood swings and prevent manicand depressive episodes.


4/21

ManiaMania can be a symptom of a medical condition, a psychologicalcondition or can be triggered by substance abuse. Some featuresof mania include: extreme elevated mood or euphoria

grandiosity high energy irritability rapid speech racing thoughts decreased sleep impulsiveness risky sexual behaviors

excessive spending


5/21

Depression2- Depression is a "whole-body" illness, involvingyour (body, mood, and thoughts. It affects theway you eat and sleep, the way you feel about

yourself, and the way you think about things).People with a depressive illness cannot merely"pull themselves together" and get better.Without treatment, symptoms can last for weeks,

months, or years. Appropriate treatment,however, can help most people who suffer fromdepression.


6/21

Classic Mood Stabilizer:* Antimanic : Lithium Carbonate(Carbolith), first and typical mood stabilizer

* Anticonvulsants:

Carbamazepine(Tegretol), anticonvulsant and mood stabilizer Oxcarbazepine (Trileptal), anticonvulsant and mood stabilizer Valproic acid, and Valproic acid salts (Depakine, Depakote),

anticonvulsant

and mood stabilizer Lamotrigine(Lamictal), atypical anticonvulsant and mood stabilizer Gabapentin, atypical GABA-related anticonvulsant and mood

stabilizer Pregabalin, atypical GABA-ergic anticonvulsant and mood stabilizer Topiramate, GABA-receptor related anticonvulsant and mood-

stabilizer Olanzapine, atypical antipsychotic and mood stabilizer
http://en.wikipedia.org/wiki/Lithium_Carbonatehttp://en.wikipedia.org/wiki/Carbamazepinehttp://en.wikipedia.org/wiki/Oxcarbazepinehttp://en.wikipedia.org/wiki/Valproic_acidhttp://en.wikipedia.org/wiki/Lamotriginehttp://en.wikipedia.org/wiki/Gabapentinhttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Pregabalinhttp://en.wikipedia.org/wiki/Topiramatehttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Olanzapinehttp://en.wikipedia.org/wiki/Olanzapinehttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Topiramatehttp://en.wikipedia.org/wiki/Pregabalinhttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Gabapentinhttp://en.wikipedia.org/wiki/Lamotriginehttp://en.wikipedia.org/wiki/Valproic_acidhttp://en.wikipedia.org/wiki/Oxcarbazepinehttp://en.wikipedia.org/wiki/Carbamazepinehttp://en.wikipedia.org/wiki/Lithium_Carbonate


7/21

Classic Mood Stabilizer:* Calcium channel blocker :

Verapamil (isoptin)

* Antipsychotic :

Olanzapine (zyprexa)


8/21

lithiumMechanism of action :

Not fully understood , but may enhance

reuptake of norepinephrine and serotonin , decreasingthe level in the body , resulting in decreasedhyperactivity ( may take 1-3 wks for symptoms )

Lithium has been the predominant treatment for mania

.


9/21

Getting the right dose Its based on how much of the drug is inyour blood and how you respond to

treatment.

This means that the dose differs for everyonewho takes it. Blood samples are taken

regularlyto make sure that the dose is neither too high

nor too lowOn days that you are scheduled to have yourblood level tested, wait until after the test totake your morning dose to avoid inaccurateresults.


10/21

lithium overdoseThe margin between the therapeutic and toxiclevels of lithium carbonate is very narrow , theusual ranges of therapeutic serum

concentrations are :For acute mania : 1,0 to 1,5 mEq/L

For maintenance : 0,6 to 1,2 mEq/L

Serum lithium levels should be monitored once

or twice a week after initial treatment untilserum level are stable , then monthly duringmaintenance .


11/21

Lithium toxicitySymptoms of lithium toxicity begin to appear at bloodlevel greater than 1,5 mEq/L , symptoms include :

1- at serum level of 1,5 to 2,0 : blurred vision , tinnitus ,

nausea , vomiting , sever diarrhea2- at serum level of 2,0 to 3,5 : excessive output , increasetremors , psychomotor retardation , confusion

3- at serum level above 3,5 : impaired consciousness ,seizures , coma , oliguria , anuria , cardio vascularcollapse .


12/21

Signs of lithium overdoseLithium blood levels can increase to dangerouslevelswhen a person becomes severelydehydrated.Remember to drink eight to 12cups of fluid perday, especially when its hotorwhen youre

exercising. Severe vomiting,diarrhea or a fevercan also cause dehydration.

If you have these symptoms, stop takinglithium andsee your doctor as soon as possible.Changing theamount of salt you use can alsoaffect lithiumlevels: avoid low- or no-salt diets.

Signs that the amount of lithium in the body ishigher than it should be include severe nausea,vomiting and diarrhea, shaking and twitching,loss of balance, slurred speech, double visionandweakness.


13/21

Signs of lithium overdoseIn addition to :

Taking mood stabilizers may reduce your interest in Sex

and some men who take lithium report a decreasedability to maintain an erection or to ejaculate .

In women, mood stabilizers may cause changes

in the menstrual cycle


14/21

Note !!!1- pre assessment of renal functioning should beperformed

2- Lithium is similar to sodium

3- Ensure that client consumes adequate fluid intake2,500 to 3,000 ml of fluid per day

4- Accurate records of intake and output .


15/21

Anticonvulsantsanticonvulsants used in the treatment of mooddisorders.

Reduces neuronal activity by: -Reducing flux of ions through voltage-gated ion

channels, such as Na+, K+, Ca2+

-Enhancing inhibitory neurotransmission with

GABA, by increasing its synthesis,


16/21


17/21

Medication Side Effects Nursing Implications

Calcium ChannelBlocker

( calan : isoptin )

1. Drowsiness; dizziness2. Hypotension; bradycardia

3. Nausea

4. Constipation

1. Ensure that client does notoperate dangerousmachinery or participate inactivities that requirealertness.

2. Take vital signs just beforeinitiation of therapy andbefore daily administration ofthe medication.Physician will provideacceptable parameters foradministration. Report markedchanges immediately.

3. Encourage increased fluid (ifnot contraindicated)and fiber in the diet.


18/21

Medication Side Effects Nursing Implications

AntipsychoticsOlanzapine (Zyprexa)

1. Drowsiness; dizziness2. Dry mouth; constipation

3. Increased appetite;

weight gain

1. Ensure that client does notoperate dangerousmachinery or participate inactivities that requirealertness.

2. Provide sugarless candy orgum, ice, and frequentsips of water. Provide foodshigh in fiber; encouragephysical activity and fluid ifnot contraindicated.

3. order calorie controlleddiet; provide opportunityfor physical exercise; providediet and exerciseinstruction.


19/21

SummaryMood stabilizer drugs are used primarily to treat bipolardisease ( mania , depression ) , lithium has beenpredominant treatment for mania , other majorcategories include anticonvulsants , those medicationsshould be given carefully to prevent any complicationor side effects especially the lithium , and detect anyabnormality to provide suitable and quick intervention

to the client


20/21

Referances* psychiatric mental health nursing

5 edition ,, moher

Manual of psychiatric nursing care*


21/21

mood stabilizing agents (2)

Documents