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Methylphenidate (Ritalin) classification Answer: CNS Stimulant
Methylphenidate (Ritalin) Indication Answer: Treat ADD/ ADHD
Also used to treat narcolepsy
Methylphenidate (Ritalin) Adverse reactions Answer: Insomnia
Anorexia
Weight loss
Tachycardia, palpitations, angina, dysrhythmias
Decrease growth rate & development
Methylphenidate (Ritalin) Nursing implications Answer: Careful CV fxn monitoring during tx
Psychiatric symptoms may worsen
Periodic drug "holiday"
Methylphenidate (Ritalin) Nursing implications Answer: Short acting, 2-4 hours
Teach to take at least 6 hours before bedtime if insomnia occurs
Administer 1-3 doses daily
Administer with or after meals to avoid appetite suppression
Monitor heart rate, rhythm, and BP
Monitor height and weight to detect growth suppression
Lithium Carbonate classification Answer: Mood-Stabalizing drug
Lithium Carbonate Indication Answer: Bipolar disorder
Especially manic phase
Lithium Carbonate Adverse reactions Answer: Nausea, fatigue, thirst, polyuria, & fine hand
tremors
WEight gain
Hypothyroidism
Possible renal impairment
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
, Lithium Carbonate therapeutic & toxic levels Answer: 0.4-1.3
>1.5
Lithium Carbonate signs of toxicity Answer: Fine hand tremors progressing to coarse
tremors
Mild GI upset progressing to persistent upset
Slurred speech and muscle weakness progressing to mental confusion
Lithium Carbonate signs of severe toxicity Answer: decrease LOC progressing to stupor
and finally coma
Seizures
Severe hypotension
Severe polyuria w/ dilute urine
What to do if lithium toxicity Answer: D/C lithium
Notify HCP
Lithium Carbonate teaching Answer: Lithium should be taken with food
Balanced diet w/ normal NaCl intake
2-3 liters/day fluid intake
2-3 weeks for lithium to reach therapeutic range
Assess electrolytes especially sodium
Baseline studies of renal, cardiac, and thyroid status must be obtained before lithium
therapy is begun
Use with diuretics is contraindicated. Diuretic induced sodium depletion can increase
lithium levels, causing toxicity
Valproic Acid classification Answer: Anticonvulsant Mood Stabilizer
Valproic Acid Indication Answer: Used in bipolar disorder alone or with lithium
Valproic Acid Adverse effects (8) Answer: GI: nausea, anorexia, vomiting
Hepatotoxicity
Neuro: tremor, sedation, headache, dizziness
Anticonvulsant Contraindications (Valproic acid) Answer: Hepatic disease
Renal disease
APPHIA – Crafted with Care and Precision for Academic Excellence. 2
LEARN, PRACTICE & EXCEL!
Methylphenidate (Ritalin) classification Answer: CNS Stimulant
Methylphenidate (Ritalin) Indication Answer: Treat ADD/ ADHD
Also used to treat narcolepsy
Methylphenidate (Ritalin) Adverse reactions Answer: Insomnia
Anorexia
Weight loss
Tachycardia, palpitations, angina, dysrhythmias
Decrease growth rate & development
Methylphenidate (Ritalin) Nursing implications Answer: Careful CV fxn monitoring during tx
Psychiatric symptoms may worsen
Periodic drug "holiday"
Methylphenidate (Ritalin) Nursing implications Answer: Short acting, 2-4 hours
Teach to take at least 6 hours before bedtime if insomnia occurs
Administer 1-3 doses daily
Administer with or after meals to avoid appetite suppression
Monitor heart rate, rhythm, and BP
Monitor height and weight to detect growth suppression
Lithium Carbonate classification Answer: Mood-Stabalizing drug
Lithium Carbonate Indication Answer: Bipolar disorder
Especially manic phase
Lithium Carbonate Adverse reactions Answer: Nausea, fatigue, thirst, polyuria, & fine hand
tremors
WEight gain
Hypothyroidism
Possible renal impairment
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
, Lithium Carbonate therapeutic & toxic levels Answer: 0.4-1.3
>1.5
Lithium Carbonate signs of toxicity Answer: Fine hand tremors progressing to coarse
tremors
Mild GI upset progressing to persistent upset
Slurred speech and muscle weakness progressing to mental confusion
Lithium Carbonate signs of severe toxicity Answer: decrease LOC progressing to stupor
and finally coma
Seizures
Severe hypotension
Severe polyuria w/ dilute urine
What to do if lithium toxicity Answer: D/C lithium
Notify HCP
Lithium Carbonate teaching Answer: Lithium should be taken with food
Balanced diet w/ normal NaCl intake
2-3 liters/day fluid intake
2-3 weeks for lithium to reach therapeutic range
Assess electrolytes especially sodium
Baseline studies of renal, cardiac, and thyroid status must be obtained before lithium
therapy is begun
Use with diuretics is contraindicated. Diuretic induced sodium depletion can increase
lithium levels, causing toxicity
Valproic Acid classification Answer: Anticonvulsant Mood Stabilizer
Valproic Acid Indication Answer: Used in bipolar disorder alone or with lithium
Valproic Acid Adverse effects (8) Answer: GI: nausea, anorexia, vomiting
Hepatotoxicity
Neuro: tremor, sedation, headache, dizziness
Anticonvulsant Contraindications (Valproic acid) Answer: Hepatic disease
Renal disease
APPHIA – Crafted with Care and Precision for Academic Excellence. 2
