NAME OF DRUG CLASSIFICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION RESPONSIBILITIES
GENERIC NAME: Antimanic drug Mechanism Contraindicated with CNS: Lethargy, Give with caution and
Carbolith (CAN), Dur of lithium is not hypersensitivity slurred daily monitoring of serum
alith (CAN), Eskalith,  known; alters to tartrazine; speech, muscle lithium levels to patients
Eskalith CR, Lithane  sodium transport in significant renal or CV weakness, fine with renal or CV disease,
(CAN) nerve and muscle disease; severe hand tremor debilitation, or
cells; inhibits release debilitation, dehydration or life-
BRAND NAME: of norepinephrine a dehydration; sodium GI: Nausea, threatening psychiatric
Lithium nd dopamine, but depletion, patients vomiting, disorders.
not serotonin, from on diuretics (lithium diarrhea, thirst
DOSE: stimulated neurons; decreases Give drug with food or
600 mg slightly sodium reabsorption, GU: Polyuria milk or after meals.
increases intraneuro and hyponatremia inc
ROUTE: nal stores reases lithium BLACK BOX
Oral (tablets, of catecholamines; retention); use of ACE WARNING: Monitor
capsules)
decreases intraneur inhibitors; pregnancy; clinical status closely,
onal content of lactation. especially during initial
second messengers stages of therapy;
and may thereby Use cautiously with monitor for therapeutic
selectively modulate protracted sweating serum levels of 0.6–
the responsiveness and diarrhea; suicidal 1.2 mEq/L; toxicity is
of hyperactive or impulsive patients; closely related to serum
neurons that might infection with fever. levels.
contribute to the
manic state. INDICATION Individuals vary in
Treatment of manic their reponse to this
episodes of manic- drug; some patients may
depressive illness; exhibit toxic signs at
maintenance therapy serum lithium levels
to prevent or considered within the
diminish frequency therapeutic range.
and intensity of
subsequent manic Advise patient that this
episodes drug may cause serious
fetal harm and cannot be
Unlabeled use: used during pregnancy;
Improvement urge use of barrier
of neutrophil counts contraceptives.
in patients with
cancer Decrease dosage after
chemotherapy– the acute manic
induced neutropenia  episode is controlled;
and in children with lithium tolerance is
chronic neutropenia  greater during the acute
and HIV manic phase and
patients on zidovudin decreases when manic
e therapy (doses of symptoms subside.
300–1,000 mg/day,
serum levels of 0.5 WARNING: Ensure that
and 1 mEq/L); patient maintains
prophylaxis of cluster adequate intake of salt
headache and cyclic and adequate intake of
migraine headache, fluid (2,500–
treatment of SIADH, 3,000 mL/day).
hypothyroidism
(doses of 600–
900 mg/day)