Reference no: EM133510876

Question: Mei Kimura is a 29-year-old Japanese person (pronouns they/them/their) who comes to see you in your office after they were hospitalized for 14 days for a manic episode. Mei has bipolar I disorder. They are 5' 8" and 150 pounds.

From your perspective as Mei's psychiatric nurse practitioner, answer your group's questions in a video that is 15 to 20 minutes long. Include at least three peer-reviewed, evidence-based references.

Group 2: Depakote ER

Mei has currently prescribed 1,500 mg of divalproex sodium (Depakote ER). Their most recent VPA level was 45 µg/ml.

1. What psychiatric disorders and/or symptoms is Depakote FDA-indicated to treat? 
2. What phase of bipolar (such as manic, mixed, depressed) is Depakote most effective in managing? 
3. How does Depakote work; what is the mechanism of action? 
4. What formulations does Depakote come in? What dosing differences are there (if any) based on the formulation (such as frequency, starting dose, and so on)? 
5. What laboratory testing should be ordered before starting Depakote? 
6. What is the normal reference range for monitoring Depakote levels? 
7. Based on their Depakote level and how they present to you, what changes (if any) would you make with Mei's Depakote ER? Why? Provide the dose, route, and timing/frequency for all medication changes. 
8. When would you check another Depakote level (that is, how many days after starting or changing the dose, what time of day/how long after the last dose would you check it)? 
9. Identify the most commonly expected side effects associated with Depakote about which you would educate Mei. 
10. Identify the most serious potential adverse effects associated with Depakote about which you would educate Mei to immediately report. 
11. Identify any drug-drug, food-drug, substance-drug, or herb-drug interactions that Mei should avoid while taking Depakote.