Drug Care Mood Stabilizing Antiepileptic Agend Lamotrigine - Copy - Drug Card

Drug Card – Mood-Stabilizing Antiepileptic Agent: Lamotrigine

Action: Stabilizes neuronal membranes by inhibiting sodium transport

Indications: Adjunct treatment of partial seizures in adults and children older than 2. Also used to delay

mood episodes in bipolar clients

Warnings: Pregnancy. If taking together with valproic acid or Depakote, a serious skin rash may be more

likely. Do not take the drug if allergic to lamotrigine. Client should let provider know if history of kidney,

liver, or heart disease

Undesirable Effects: Ataxia, dizziness, drowsiness, blurred vision, headache, N/V, photosensitivity, rash.

Stevens-Johnson syndrome, fever, sore throat, swollen glands, behavior changes, mood changes

(depression, anxiety, agitation). Suicidal ideation

Other Specific Information: Concurrent use with carbamazepine may result in decreased levels of

lamotrigine and increased levels of an active metabolite of carbamazepine. Levels are decreased by

concurrent use of phenobarbital, phenytoin, or primidone. Concurrent use with valproic acid results in a

twofold increase in levels, increased incidence of rash, and decrease in valproic acid level. Oral

contraceptives may decrease serum levels.

Interventions: Monitor labs for renal function; monitor of plasma levels of Lamictal (proposed

therapeutic range if 1-5 mcg/mL. Do not miss scheduled appointments with provider of care. Assess for

skin rash, and d/c at first sign of rash (may be life-threatening). Stevens-Johnson syndrome or toxic

epidermal necrolysis may develop. Rashh usually occurs during initial 2-8 weeks and is more frequent

when taking multiple antiepileptic drugs, esp valproic acid. Clients < 16 at higher risk. Assess/monitor

for hypersensitivity. Assess seizures. Assess mood, ideation and behaviors frequently. Initial suicide

precautions as indicated PO may be administered with or without food. D/C gradually. Can swallow

whole, chewed, or dispersed in water or juice. If chewed, follow with fluids. Only use whole tablets.

Educations: May impair vision or ability to react in situations/reaction time. Check with provider or

pharmacy about multiple drug-drug interactions r/t this medication. Do not d/c abruptly. Notify

provider of rash or other adverse reactions. Initiate safety precautions due to drowsiness, dizziness, and

possible blurred vision. Use sunscreen. Report changes in mood or suicidal thoughts.

Evaluation: Decrease in frequency or cessation of seizures. Decrease in mood swings in bipolar d/o.

Drug: lamotrigine (Lamictal)

Drug Care Mood Stabilizing Antiepileptic Agend Lamotrigine - Copy