Cebu Normal University

College of Nursing
PSYCHOTROPIC DRUG STUDY IN
PSYCHIATRY AS A NURSING SPECIALTY
DRUG DATA CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS SIDE EFFECT/
ADVERSE
REACTIONS
NURSING RESPONSIBILITIES
GENERIC NAME:
Valproic Acid
TRADE NAME:
Alepti! Depaco"!
Depa#e"e! Epi$al!
Dep#ote! Depa#ote ER
PATIENTS DOSE:
MINIMUM DOSE:
%&' ()/da*
MAXIMUM DOSE:
+ )/da*
CONTENTS:
diprop*lacetic acid!
cor" oil! FD,C -ello.
No/ 0! )elati"! )l*ceri"!
iro" o1ide!
(et2*lpara3e"!
prop*lpara3e"! a"d
tita"i4( dio1ide/
PHARMACOLOGIC:
Car3o1*lic acid
deri$ati$e
THERAPEUTIC:
A"tico"$4l5a"t! (ood
5ta3ilier! a"ti(i)rai"e
a)e"t
PREGNANCY
CATEGORY:
D
I"crea5e5 le$el o6 )a((a7
a(i"o34t*ric acid i" 3rai"!
red4ci") 5ei4re acti$it*
PHARMACOKINETICS:
A: Rapid a35orptio" 6ro(
)a5troi"te5ti"al tract/
M: (eta3olied al(o5t
e"tirel* 3* t2e li$er
E: Le55 t2a" 89 o6 a"
ad(i"i5tered do5e i5 e1creted
4"c2a")ed i" 4ri"e
Half-life: :7+0 2o4r5
Protei !i"i#: :'9
protei" 3o4"d
ROUTE: PO ;cap54le5<
ONSET: Rapid
PEAK: +7= 2o4r5
DURATION: 07%= 2o4r5
ROUTE: PO ;5*r4p<
ONSET: Rapid
PEAK: +&7+%' 2o4r5
DURATION: 07%= 2o4r5
ROUTE: PO ;dela*ed!
e1te"ded<
ONSET: U"#"o."
GENERAL
INDICATIONS:
7 Co(ple1 partial
5ei4re5
7 Si(ple or co(ple1
a35e"ce 5ei4re5
7 Ma"ia a55ociated
.it2 3ipolar di5order
7 To pre$e"t
(i)rai"e
PATIENTS
ACTUAL
INDICATIONS:
CONTRAINDICA-
TIONS:
- H*per5e"5iti$it* to dr4)
or tartai"e ;5o(e
prod4ct5<
- Hepatic i(pair(e"t
- Urea c*cle di5order5
- Pre)"a"ac*
PRECAUTIONS:
U5e ca4tio45l* i">
7 3leedi") di5order5!
or)a"ic 3rai" di5ea5e!
3o"e (arro. depre55io"!
re"al i(pair(e"t
7 po5ttra4(atic 5ei4re5
ca45ed 3* 2ead i"?4r*
;45e "ot reco((e"ded<
7 2i5tor* o6 2epatic
di5ea5e
7 3rea5t6eedi") patie"t5
7 c2ildre"
DRUG
INTERACTIONS:
DRUG TO DRUG
7 Acti$ated c2arcoal!
c2ole5t*ra(i"e>
decrea5ed $alproate
CNS> co"645io"!
dii"e55!
2eadac2e!
5edatio"! ata1ia!
pare5t2e5ia!
a5t2e"ia! tre(or!
dro.5i"e55!
e(otio"al
lia3ilit*!
a3"or(al
t2i"#i")!
a("e5ia
EENT>
a(3l*opia!
3l4rred $i5io"!
"*5ta)(45!
ti""it45!
p2ar*")iti5
GI> Na45ea!
$o(iti")!
diarr2ea!
a3do(i"al pai"!
d*5pep5ia!
a"ore1ia!
pa"creatiti5
He(atolo)ic>
le4cope"ia!
t2ro(3oc*tope"i
a
$E%ORE:
+/ Ta#e $ital 5i)"5 prior to
ad(i"i5tratio"/
%/ Co"6ir( (edicatio" o" (edicatio"
tic#et! (edicatio" 52eet! a"d doctor@5
order5/
8/ P2*5ical> Aei)2tB 5#i" color! le5io"5B
orie"tatio"! a66ect! re6le1e5B 3o.el
5o4"d5! "or(al o4tp4tB CBC a"d
di66ere"tial! 3leedi") ti(e te5t5! LFT5!
5er4( a((o"ia le$el! e1ocri"e
pa"creatic 64"ctio" te5t5! EEG
=/ Hi5tor*> H*per5e"5iti$it* to $alproic
acidB 2epatic i(pair(e"tB pre)"a"c*!
lactatio"
&/ Per6or( 2a"d.a52i") prior to
ad(i"i5tratio"/

DURING:
+/ Gi$e dr4) .it2 6ood i6 GI 4p5et
occ4r5
%/ Greet pt/ a"d SO! $eri6* clie"t
ide"tit* ;$er3al! pt/ ta)5! 3ed "4(3er</
A55e55 3a5eli"e $/5
8/ Do"@t )i$e 5*r4p i" car3o"ated
3e$era)e5 ;(a* ca45e (o4t2 a"d t2roat
irritatio"<
=/ Gi$e IV o"l* .2e" oral t2erap* i5"@t
6ea5i3le/
&/ For IV 45e! dil4te $alproate 5odi4(
A&AILA$ILITY '
COLOR:
Cap54le5 ;liC4id76illed<>
%&' ()
I"?ectio"> +'' ()/(l i"
&7(l $ial
S*r4p> %&o ()/& (l
Cap54le5 ;co"tai"i")
coated particle5 or
5pri"#le5<> +%& ()
Ta3let5 ;e"teric7coated!
dela*ed7relea5e<> +%&
()! %&' ()! &'' ()
Ta3let5 ;e1te"ded7
relea5e<> %&' ()! &''
()
ROUTE(S O%
ADMINISTRATION:
P/ O/! I/V/
PEAK: U"#"o."
DURATION: U"#"o."
ROUTE: I/V/
ONSET: Rapid
PEAK: E"d o6 + 2o4r
i"645io"
DURATION: U"#"o."
THERAPEUTIC LE&ELS:
&' D %'' (c)/(l
a35orptio"
7 A"tiplatelet a)e"t5
;i"cl4di") a3ci1i(a3!
a5piri" a"d ot2er
"o"5teroidal a"ti7
i"6la((ator* dr4)5!
epti6i3atide! tiro6i3a"<!
ce6a(a"dole!
ce6operao"e! ce6oteta"!
2epari"! t2ro(3ol*tic5!
.ar6ari"> i"crea5ed ri5#
o6 3leedi")
7 Bar3it4rate5!
pri(ido"e> decrea5ed
(eta3oli5( a"d )reater
ri5# o6 to1icit* o6 t2e5e
dr4)5! decrea5ed
$alproate e66icac*
7 Car3a(aepi"e>
i"crea5ed car3a(aepi"e
3lood le$el! decrea5ed
$alproate 3lood le$el!
poor 5ei4re co"trol
7 C2lorpro(ai"e>
decrea5ed $alproate
cleara"ce a"d i"crea5ed
tro4)2 le$el
7 Ci(etidi"e> decrea5ed
$alproate cleara"ce
7 Clo"aepa(> a35e"ce
5ei4re5 i" patie"t5 .it2
2i5tor* o6 t2e5e 5ei4re5
7 CNS depre55a"t5 ;54c2
a5 a"ti2i5ta(i"e5 a"d
a"tidepre55a"t5! MAO
i"2i3itor5! opioid
a"al)e5ic5! 5edati$e7
2*p"otic5<> additi$e CNS
depre55io"
7 Diaepa(>
di5place(e"t o6
diaepa( 6ro( 3i"di")
Hepatic>
2epatoto1icit*
M45c4lo5#eletal>
3ac# pai"
Re5pirator*>
d*5p"ea
S#i"> ra52!
alopecia! 3r45i")
Ot2er> a3"or(al
ta5te! i"crea5ed
appetite! .eo)2t
)ai"! 6l4li#e
5*(pto(5!
i"6ectio"!
i"645io" 5ite pai"
a"d reactio"
i" at lea5t &' (l o6 de1tro5e &9 i"
.ater! lactated Ri")er@5 5ol4tio"! or
"or(al 5ali"e 5ol4tio"/ I"645e o$er +
2o4r at a rate 5lo.er t2a" %'
()/(i"4te/
A%TER:
+/ Clo5el* (o"itor "e4rolo)ic 5tat45/
Aatc2 6or 5ei4re5/
%/ E$al4ate GI 5tat45/ Sta* alert 6or
5i)"5 a"d 5*(pto(5 o6 pa"creatiti5/
8/ Ad$i5e patie"t to i((ediatel* report
(alai5e! .ea#"e55! let2ar)*! appetite
lo55! $o(iti") or *ello.i") o6 5#i" or
e*e5
=/ DOCUMENT 2o4r! a(o4"t!
(edicatio" a"d dr4) reactio" ;i6 a"*<
&/ Ca4tio" patie"t "ot to 5top t2erap*
a3r4ptl*/
5ite! i"2i3ited diaepa(
(eta3oli5(
7 Er*t2ro(*ci"!
6el3a(ate> i"crea5ed
$alproate 3lood le$el!
)reater ri5# o6 to1icit*
7 Et2o541i(ide> i"2i3ited
et2o541i(ide
(eta3oli5(
7 La(otri)i"e> decrea5ed
$alproate 3lood le$el!
i"crea5ed la(otri)i"e
3lood le$el
7 P2e"*toi"> i"crea5ed
p2e"*toi" e66ect5 a"d
ri5# o6 to1icit*!
decrea5ed $alproate
e66ect5
7 Salic*late5 ;lar)e do5e5
i" c2ildre"<> i"crea5ed
$alproate e66ect5
7 Tric*clic
a"tidepre55a"t5>
i"crea5ed 3lood le$el5 o6
t2e5e dr4)5! )reater ri5#
o6 ad$er5e reactio"5
7 Eido$4di"e> decrea5ed
ido$4di"e cleara"ce i"
patie"t5 .it2 24(a"
i((4"ode6icie"c* $ir45
FOOD TO DRUG
- No"e
So4rce> Sc24ll! P/ D/
;%'+'</ N4r5i")
Spectr4( Dr4)
Ha"d3oo#/ Ne.
-or#! N-> McGra.
Hill/ ;pp +%+07+%+:<
So4rce> Sc24ll! P/ D/
;%'+'</ N4r5i")
Spectr4( Dr4)
Ha"d3oo#/ Ne. -or#!
N-> McGra. Hill/ ;pp
+%+07+%+:<
So4rce> Sc24ll! P/ D/ ;%'+'</
N4r5i") Spectr4( Dr4)
Ha"d3oo#/ Ne. -or#! N->
McGra. Hill/ ;pp +%+07
+%+:<
2ttp>//.../dr4)3a"#/ca/dr4)
5/DB''8+8
So4rce> Sc24ll! P/ D/
;%'+'</ N4r5i")
Spectr4( Dr4)
Ha"d3oo#/ Ne.
-or#! N-> McGra.
Hill/ ;pp +%+07+%+:<
So4rce> Sc24ll! P/ D/
;%'+'</ N4r5i")
Spectr4( Dr4)
Ha"d3oo#/ Ne. -or#!
N-> McGra. Hill/ ;pp
+%+07+%+:<
So4rce>
Sc24ll! P/ D/
;%'+'</
N4r5i")
Spectr4(
Dr4)
Ha"d3oo#/
Ne. -or#!
N->
McGra.
Hill/ ;pp
+%+07+%+:<
So4rce> Sc24ll! P/ D/ ;%'+'</ N4r5i")
Spectr4( Dr4) Ha"d3oo#/ Ne.
-or#! N-> McGra. Hill/ ;pp +%+07
+%+:<