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Antimanic Drugs

This document provides information about lithium carbonate (Eskalith) including its use as an antimanic drug, mechanism of action, side effects, toxicity, monitoring, and alternatives. It describes how lithium carbonate works to decrease hyperactivity in mania and is best taken with meals. It also outlines signs of lithium toxicity including vomiting, tremors, and seizures at very high levels. Monitoring of serum lithium levels and management of toxicity is discussed.

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Ghee Evangelista
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437 views13 pages

Antimanic Drugs

This document provides information about lithium carbonate (Eskalith) including its use as an antimanic drug, mechanism of action, side effects, toxicity, monitoring, and alternatives. It describes how lithium carbonate works to decrease hyperactivity in mania and is best taken with meals. It also outlines signs of lithium toxicity including vomiting, tremors, and seizures at very high levels. Monitoring of serum lithium levels and management of toxicity is discussed.

Uploaded by

Ghee Evangelista
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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ANTIMANIC DRUGS

LITHIUM CARBONATE
C- Antimanic
H- decreased hyperactivity
E- best taken after meals
C- increase fluid intake (3 L/day) and
sodium intake (3 gm/day)
Avoid activities that increase
perspiration
K- It takes 10-14 days before
therapeutic effect becomes evident
Antipsychotic is administered during
the first two weeks to manage the
acute symptoms of mania until lithium
takes effect
Monitor serum level: normal is .6 to
1.2 meq/L
Mannitol is administered if toxicity
occurs
Trade names include: Quilonium, Eskalith,
Lithotabs, Lithane, Lithonate
MECHANISM OF ACTION
Exact mechanism is not known.
Lithium is thought to enhance the reuptake
of the biogenic amines in the brain, thus
lowering their levels in the body.
Another theory suggests that it alters
sodium metabolism within nerve and
muscle cells.
SIDE EFFECTS OF LITHIUM
D ry mouth
I rregular pulse
GI upset
F ine hand tremors
U rination frequent
N ausea
LITHIUM TOXICITY
Vomiting
Abdominal discomforts
Nausea
Diarrhea
Tremor of hand
Drowsiness
SEVERE TOXICITY
>2.5 mEq/l
Seizures
Coma
Cardiovascular collapse
Death!!
Management of Lithium Toxicity
Discontinue the drug immediately
Induction of emesis, gastric lavage and
adsorption with activated charcoal.
If possible, instruct client to ingest fluids.
Assess serum lithium levels, serum
electrolytes, renal functions, ECG as soon as
possible.
Maintenance of fluid and electrolyte balance.
In a patient with serious manifestations of
lithium toxicity, hemodialysis should be
initiated.
Common Causes for an Increase
in Lithium Levels
Decrease sodium intake
Diuretic therapy
Decrease renal functioning
Fluid/electrolyte loss; sweating,
diarrhea and dehydration
Medical illness
Overdose
Contraindication of Lithium Use

Cardiovascular disorder
Renal disease
Thyroid disorder
Dehydration
Concurrent with diuretics
Pregnancy
Children below 12 years of age.
LITHIUM LAB MONITORING
Usual maintenance level 0.6 – 1.2 mEq/L
Usually drawn 12 hours after last dose
Must be taken first thing in the morning,
before medication is given
During the first month- weekly blood
draws
2nd & 3rd months- biweekly
If stable then levels are done every 6 to
12 months thereafter
OTHER DRUGS WITH
ANTIMANIC PROPERTY

Valproic acid (Depakene)


Tegretol (Carbamazepine)
Klonopin (Clonazepam)
Note: These drugs are also anti-
convulsant drugs.
1. A nurse is caring for a manic patient who
is receiving Lithium carbonate (Eskalith).
Before administration of the next dose,
the nurse finds that the patient’s lithium
blood level is 1.6 mEq/L. Which of the
following actions should the nurse take
first?
A. Call the patient’s physician
B. Withhold the dose
C. Take the patient’s blood pressure
D. Repeat the blood lithium level

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