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% Document Info
\author{adrianao}
\pdfinfo{
  /Title (mood-stabilizing-antiepileptics.pdf)
  /Creator (Cheatography)
  /Author (adrianao)
  /Subject (Mood Stabilizing Antiepileptics Cheat Sheet)
}

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\noindent
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Mood Stabilizing Antiepileptics Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{adrianao} via \textcolor{DarkBackground}{\uline{cheatography.com/168237/cs/35340/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}adrianao \\
  \uline{cheatography.com/adrianao} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 8th November, 2022.\\
   Updated 8th November, 2022.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Medications}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Carbamazepine} \tn 
% Row Count 1 (+ 1)
% Row 1
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\mymulticolumn{1}{x{5.377cm}}{Valproic Acid} \tn 
% Row Count 2 (+ 1)
% Row 2
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\mymulticolumn{1}{x{5.377cm}}{Lamotrigine} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Oxcarbazepine and topiramate are less frequently used and recommended for maintenance treatment of bipolar disorder.} \tn 
% Row Count 6 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Purpose}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Heal treat and manage bipolar disorders by various mechanisms} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Slowing the entrance of sodium and calcium back into the neuron and thus extending the time it takes for the nerve to return to its active state} \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Inhibiting glutamic acid (glutamate) which in turn suppresses CNS excitation} \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Therapeutic Uses}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Treatment and prevention of relapse of manis and depressive episodes} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Especially useful for clients who have mixed mania and rapid cycling bipolar disorders} \tn 
% Row Count 4 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications of Lamotrinige}}  \tn
% Row 0
\SetRowColor{LightBackground}
Complication & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Double vision, blurred vision, dizziness, headache, nausea, and vomiting & Caution clients about performing activities requiring concentration or visual acuity \tn 
% Row Count 7 (+ 5)
% Row 2
\SetRowColor{LightBackground}
Serious skin rashes: stevens-johnsons syndrome & Instruct clients to withhold medications and notify the provider if rash occurs. To minimize the risk of serious rash, the initial dosage should be low and advanced slowly \tn 
% Row Count 16 (+ 9)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Contraindications/ Precautions}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Carbamazepine and valproic acid are pregnancy risk category D and can result in birth defects} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Lamotrigine is a pregnancy risk category C, but can cause cleft lip and paleet if taken during the first trimester. Clients should discuss breastfeeding while taking lamotrigine with the provider} \tn 
% Row Count 6 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Carbamazepine is contraindicated in clients who have bone marrow suppression or bleeding disorders. Clients should avoid breastfeeding} \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Valproic acid is contraindicated in clients who have liver disorders. Clients of child-bearing potential should use contraception while taking valproic acid} \tn 
% Row Count 13 (+ 4)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Monitor plasma valproic acid and Carbamazepine levels while undergoing treatment. The therapeutic blood level range for Carbamazepine is 4 to 12 mcg/mL. Therapeutic blood level range for valproic acid is 50 to 120 mcg/mL.} \tn 
% Row Count 18 (+ 5)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications of Carbamazepine}}  \tn
% Row 0
\SetRowColor{LightBackground}
Complication & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
CNS effects: Cognitive function is minimally affected, but CNS effects can include nystagmus, double vision, vertigo, staggering gait, and headaches & Administer low dose initially, then gradually increase dose. Administer dose at bedtime. Avoid driving and other activities that involve alertness at the beginning of treatment. CNS effects should subside within a few weeks \tn 
% Row Count 14 (+ 12)
% Row 2
\SetRowColor{LightBackground}
Blood Dyscrasias: leukopenia, anemia, thrombocytopenia & Obtain baseline CBC, and platelet, and perform ongoing monitoring. Observe for indications of bruising and bleeding of gums. Monitor and report sore throat, fatigue, or other indications of infection or bleeding \tn 
% Row Count 25 (+ 11)
% Row 3
\SetRowColor{white}
Teratogenesis & avoid use in pregnancy \tn 
% Row Count 27 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Hypo-osmolality: promotes secretion of ADH, which inhibits water excretion by the kidneys and places clients who have heart failure at risk for fluid overload. & Monitor blood levels of sodium levels. Monitor for edema, decreased urine output, and hypertension \tn 
% Row Count 35 (+ 8)
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\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications of Carbamazepine (cont)}}  \tn
% Row 5
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Skin disorders: dermatitis, rash, stevens-Johnson syndrome (which is potentially life threatening) & Treat mild reactions with anti-inflammatory or antihistamine medications. Wear sunscreen. Notify provider if stevens-johnsons syndrome rash occurs and withhold medication \tn 
% Row Count 9 (+ 9)
% Row 6
\SetRowColor{white}
Hepatotoxicity: evidenced by anorexia, nausea, vomiting, fatigue, abdominal pain, and jaundice & Assess baseline liver function, and monitor liver function regularly. Avoid using in children under 2. Administer lowest effective dose. observe for indications and notify provider if they occur. \tn 
% Row Count 19 (+ 10)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications of Valproic Acid}}  \tn
% Row 0
\SetRowColor{LightBackground}
Complication & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
GI Effects: nausea, vomiting, indigestion & Manifestations are usually self-limiting. Take medications with food or switch to enteric coated pills to reduce GI effects. \tn 
% Row Count 9 (+ 7)
% Row 2
\SetRowColor{LightBackground}
Hepatotoxicity: anorexia, nausea, vomiting, fatigue, abdominal pain, jaundice & Assess liver function, and monitor liver function regularly. Avoid using in children younger than 2. Administer lowest effective dose. Notify provider if they occur. \tn 
% Row Count 18 (+ 9)
% Row 3
\SetRowColor{white}
Pancreatitis: nausea, vomiting, abdominal pain & Monitor amylase levels. Discontinue medication if pancreatitis develops \tn 
% Row Count 22 (+ 4)
% Row 4
\SetRowColor{LightBackground}
Thrombocytopenia & monitor platelet counts. Observe for manifestations (bruising) and notify the provider \tn 
% Row Count 27 (+ 5)
% Row 5
\SetRowColor{white}
Teratogenesis & Avoid use in pregnancy \tn 
% Row Count 29 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Weight Gain & Follow a healthy low calorie diet, engage in regular exercise, and monitor weight \tn 
% Row Count 34 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Interactions for Carbamazepine}}  \tn
% Row 0
\SetRowColor{LightBackground}
Indications & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Oral contraceptive, warfarin & Concurrent use causes a decrease in the effects of these medications due to stimulation of hepatic metabolizing enzymes. Monitor for therapeutic effects of warfarin. Dosage can be adjusted. \tn 
% Row Count 12 (+ 10)
% Row 2
\SetRowColor{LightBackground}
Grapefruit juice: inhibits metabolism, thus increasing carbamazepine levels & avoid intake of grapefruit juice \tn 
% Row Count 16 (+ 4)
% Row 3
\SetRowColor{white}
Phenytoin and phenobarbital: decrease the effects of carbamazepine by stimulating metabolism & Monitor phenytoin and phenobarbital levels. Adjust dosage of medications as prescribed \tn 
% Row Count 21 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Interactions for Lamotrigine}}  \tn
% Row 0
\SetRowColor{LightBackground}
Interaction & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Carbamazepine, phenytoin, and phenobarbital: these promote liver drug metabolizing enzymes, thereby decreasing the effect of lamotrigine & Monitor for therapeutic effects. Adjust dosage of medications as prescribed \tn 
% Row Count 9 (+ 7)
% Row 2
\SetRowColor{LightBackground}
Oral contraceptives: Lamotrigine can reduce progestin levels, estrogen-containing contraceptives can reduce leveles of lamotrigine & Lamotrigine dosage change can be required when beginning or stopping oral contraceptive therapy \tn 
% Row Count 16 (+ 7)
% Row 3
\SetRowColor{white}
Valproic Acid: inhibits metabolizing and thus increases the half life of lamotringe & Monitor for adverse effects. adjust dosage of medication as prescribed \tn 
% Row Count 21 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Interactions of Valproic Acid}}  \tn
% Row 0
\SetRowColor{LightBackground}
Interaction & Nursing Action and Education \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Phenytoin and Phenobarbital: blood levels of these medications are increased when used concurrently with valproic acid & Monitor phenytoin and phenobarbital levels. Adjust dosage of medications as prescribed. \tn 
% Row Count 8 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Nursing Evaluation of Medication Effectiveness}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Depending on therapeutic intent, effectiveness is evidenced by the following} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Relief of manifestations of acute mania (flight of ideas, excessive talking, agitation) or depression (fatigue, poor appetite, psychomotor retardation)} \tn 
% Row Count 6 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Mood stability} \tn 
% Row Count 7 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Ability to preform ADLs} \tn 
% Row Count 8 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Improved sleeping and eating habits} \tn 
% Row Count 9 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Appropriate interactions with peers} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}