University:
Stanford University
Course:
MED 101 | Human Anatomy
Academic year:

2023
Views:

155

Pages:

2
Author:

larbi43100

‭MONITORING ELEMENTS‬ ‭Monitoring of Thymoregulators‬ ‭The‬ ‭onset‬ ‭of‬ ‭action‬ ‭of‬ ‭a‬ ‭mood‬ ‭stabilizer‬ ‭is‬ ‭only‬ ‭observed‬ ‭after‬ ‭2‬ ‭to‬ ‭3‬ ‭weeks.‬ ‭The‬ ‭curative‬ ‭effectiveness‬ ‭is‬ ‭only‬ ‭assessed‬‭after‬‭a‬‭minimum‬‭period‬‭of‬‭5‬‭weeks.‬‭The‬‭preventive‬‭effectiveness‬‭can‬ ‭only be assessed over a period of one or two years with regular use.‬ ‭-‬‭Lithium salt monitoring‬ ‭It is preferable to initiate treatment within the framework of hospitalization.‬ ‭A‬ ‭complete‬ ‭clinical‬ ‭examination‬ ‭should‬ ‭be‬ ‭performed.‬ ‭Paraclinical‬ ‭examinations‬ ‭must‬ ‭also‬ ‭be‬ ‭requested‬ ‭with‬ ‭ECG,‬ ‭EEG,‬ ‭CBC,‬ ‭blood‬ ‭ionogram,‬ ‭blood‬ ‭sugar,‬ ‭urea,‬ ‭creatinine‬ ‭clearance,‬ ‭ultrasensitive TSH, 24-hour proteinuria, ßHCG.‬ ‭The‬ ‭therapeutic‬ ‭range‬ ‭is‬ ‭between‬ ‭0.6‬ ‭and‬‭1.2‬‭mmol/L.‬‭Once‬‭the‬‭therapeutic‬‭dose‬‭is‬‭reached,‬‭serum‬ ‭lithium levels should be monitored every 3 months.‬ ‭The diet must be standard-sodium (no salt-free diet).‬ ‭Clinical‬ ‭monitoring‬ ‭is‬ ‭required:‬ ‭weight,‬ ‭digestive‬ ‭disorders,‬ ‭sedation,‬ ‭thyroid‬ ‭goiter,‬ ‭signs‬ ‭of‬ ‭hypothyroidism,‬ ‭thirst,‬ ‭polyuria,‬ ‭skin‬ ‭manifestations‬ ‭must‬ ‭be‬ ‭regular.‬ ‭In‬ ‭addition,‬ ‭serum‬ ‭creatinine‬ ‭must‬ ‭be‬ ‭monitored‬ ‭for‬ ‭6‬ ‭months‬ ‭and‬ ‭an‬ ‭ultra‬ ‭TSH‬ ‭assay‬ ‭must‬ ‭be‬ ‭performed.‬ ‭-sensitive,‬ ‭CBC,‬ ‭ionogram, and an ECG/year.‬ ‭-‬‭Anticonvulsant monitoring:‬ ‭Valproate and carbamazepine‬ ‭A pre-therapeutic assessment is necessary including: a complete clinical examination and a biological‬ ‭assessment: CBC, coagulation assessment, ßHCG and a liver assessment.‬ ‭The therapeutic range for valproate is between 50 and 100 mg/l and that for carbamazepine between‬ ‭5 and 12 mg/l.‬ ‭Tegretolemia or depakinemia should be monitored every 3 months and hematological and hepatic‬ ‭assessment every 3 to 6 months.‬ ‭-‬‭Monitoring of atypical antipsychotics (APA)‬ ‭A‬‭complete‬‭clinical‬‭examination‬‭must‬‭be‬‭carried‬‭out‬‭before‬‭initiating‬‭treatment‬‭with‬‭weighing,‬‭blood‬ ‭pressure measurement and ECG.‬ ‭The‬‭most‬‭common‬‭side‬‭effect‬‭of‬‭atypical‬‭antipsychotics‬‭is‬‭metabolic‬‭syndrome,‬‭so‬‭weight‬‭and‬‭blood‬ ‭pressure should be monitored and a metabolic assessment should be done if warning signs appear.‬ ‭Monitoring of Antidepressants‬ ‭The‬ ‭antidepressant‬ ‭effect‬ ‭is‬ ‭only‬ ‭observed‬ ‭after‬ ‭10‬ ‭to‬ ‭15‬ ‭days‬ ‭of‬ ‭treatment.‬ ‭An‬ ‭antidepressant‬ ‭is‬ ‭considered‬ ‭ineffective‬ ‭if,‬ ‭at‬ ‭an‬ ‭adequate‬ ‭dose,‬ ‭there‬ ‭is‬ ‭no‬ ‭improvement‬ ‭after‬ ‭6‬ ‭weeks,‬ ‭or‬ ‭if‬ ‭improvement‬‭remains‬‭partial‬‭after‬‭8‬‭to‬‭12‬‭weeks‬‭of‬‭treatment.‬‭Antidepressants‬‭must‬‭be‬‭continued‬‭for‬ ‭at‬ ‭least‬ ‭6‬ ‭months‬ ‭after‬ ‭remission‬ ‭in‬ ‭the‬ ‭case‬ ‭of‬ ‭a‬ ‭first‬‭MDE,‬‭longer‬‭in‬‭the‬‭event‬‭of‬‭a‬‭recurrence‬‭in‬ ‭order to avoid relapses.‬