A nurse is reviewing medications for a patient with bipolar disorder. The nurse has received an order to discontinue the lithium and begin valproic acid (Depakene)
The nurse understands the prescriber's change of order based on which mechanism of action?
a. Valproic acid works slower and has a lower therapeutic index.
b. Valproic acid has no serious side effects.
c. Valproic acid does not require plasma drug levels.
d. Valproic acid works faster and has a higher therapeutic index.
ANS: D
Valproic acid works faster and has a higher therapeutic index than lithium, as well as a better side effect profile.
This is incorrect; in fact, valproic acid works faster and has a higher therapeutic index than lithium.
Valproic acid can have serious side effects.
Any anticonvulsant, including valproic acid, when used in a patient with bipolar disorder requires monitoring with periodic plasma drug levels.
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