Psychiatric Drug Classification Index Sheet
Worksheet to be used as a tool for collection of drug classification data to be submitted for grading.
The student will be assigned, by their clinical professor, one of the following specific psychiatric drug classifications: (Benzodiazepines, SSRI, SNRI, TCA,
MAOI, Lithium, Mood Stabilizers, 1st Generation Antipsychotics, 2nd Generation Antipsychotics). The student will research the assigned psychiatric drug
classification and complete the Psychiatric Drug Classification Index Sheet below. List the drug classification in the left column & fill in the related information in
the columns provided.
Drug
Classification
Safe Dose.
Route,
Onset, and
Frequency
Action and
Therapeutic
Response
List the drug
classification and
names of generic
drugs within the
classification
Onset: How
long until
they take
effect?
What is this drug
classification used for?
Why would a patient
receive this medication?
Lithium (Eskalith,
Lithobid) – CNS
Psychotherapeutic
Agent, Mood
stabilizer
Peak : 0.53hrs
Route/Safe
dose/
Frequency PO 300 mg
t.i.d. or q.i.d.
or 15–20 mL
(24–32 mEq)
solution in
2–4 divided
doses (max:
2.4 g/d)
Mood stabilizer used to
treat a patient who has
mood disorders such as
mania.
Side Effects/Toxicity
Common Side Effects and
Rare, but Serious Side
Effects
Expected S.E – N/V/D,
thirst, fine hand tremors,
polyuria, weight gain,
goiter.
Early toxicity – GI upset,
coarse tremors,
hyperirritability of
muscles, EEG changes,
sedation, incoordination.
Advanced toxicity –
Ataxia, serious EEG
changes, blurred vision,
seizures, severe
hypotension, pulmonary
issues.
Severe toxicity –
Convulsions, oliguria,
death
Pre – and – Post Assessments
(i.e., labs, relevant vital signs,
nursing observations), physical
assessments, teaching etc.
(Nursing Implications and Important
Patient Teaching)
- assess patient’s mental alertness first
- Lithium lab results and CBC count.
- assess renal & thyroid function.
- assess lithium levels periodically
when patient is on medication.
Note :
Therapeutic levels : 0.8-1.4
Maintenance : 0.4-1.3
Toxicity : > 1.5+
Education:
- Monitor fluid/Na+ intake, monitor
fluid loss, regular weights, take with
meals d/t GI upset, check with HCP
before taking NSAIDS, must be tapered
off to discontinue.
- do not drive or engage in hazardous
activities until response to drug is
established.
Instructor Feedback
Valproate
(Depokote) – CNS
Agent,
Anticonvulsant,
GABA Inhibitor
Carbamazepine
(Tegretol) – CNS
Agent,
Anticonvulsant
Peak: 1–4 hr
Therapeutic
Range: 50–
100 g/mL.
Route/Safe
dose/
Frequency PO/IV 15
mg/kg/d in
divided
doses when
total daily
dose >250
mg, increase
at 1 wk
intervals by
5–10
mg/kg/d
until seizures
are
controlled or
adverse
effects
develop
(max: 60
mg/kg/d)
Peak : 2-8
hrs
Route/Safe
dose/
Frequency PO 200 mg
b.i.d.,
gradually
increased to
800–1200
mg/d in 3–4
divided
doses.
Used in patients for
management of
seizures, mania,
migraines.
Used in patients with
rapid cycling periods,
severe paranoia, angry
mania, seizures.
Expected S.E – sedation,
drowsiness, N/V, bleeding.
Adverse S.E – Coma,
death (if OD), liver failure,
pancreatitis, bone marrow
depression.
Expected S.E – bone
marrow suppression, liver
inflammation, leukopenia
Adverse S.E – Heart block.
aplastic anemia,
agranulocytosis,
respiratory depression.
- assess patient’s mental alertness first.
Lab:
- baseline platelet count/time, serum
ammonia.
Education:
- refrain from alcohol.
- Do not self-medicate with OTC meds.
- do not drive or engage in hazardous
activities until response to drug is
established.
- assess patient’s mental alertness first.
Lab:
- baseline & periodic CBC (platelets,
electrolytes, iron, BUN, urinalysis)
- monitor I/O, cardiac function
- monitor neuro and mental cognition
Education:
- discontinue if S&S f toxicity
(anorexia, fever, sore throat, fatigue,
bleeding from areas)
- refrain from alcohol.
- Do not self-medicate with other
meds/OTC meds.
- do not drive or engage in hazardous
activities until response to drug is
established.
- Do not stop abruptly.
Lamotrigine
(Lamictal) – CNS
agent,
Anticonvulsant
Onset: 12
weeks, Peak
1-4 hrs
Route/Safe
dose/
Frequency PO Start
with 25 mg
q.d. for 2
wk, then 50
mg q.d. for 2
wk, then 100
mg/d for 1
wk, then 200
mg q.d.
Used in patients with
partial seizures, bipolar
and mood disorders.
Expected S.E – dizziness,
ataxia, drowsiness,
headache, nausea, blurred
vision
Adverse S.E – Steven
Johnsons Sydrome, toxic
epidermal necrolysis
(rash).
- Always assess patient’s mental
alertness first.
Lab:
- monitor plasma levels of the drug.
Education:
- Do not self-medicate with other
meds/OTC meds.
- do not drive or engage in hazardous
activities until response to drug is
established.