Lithium Flashcards
1
Q
what is lithium?
A
mood stabilising drug
2
Q
what is the therapeutic range of lithium?
A
0.4-1.0 mmol/L
3
Q
what organ excrets lithium?
A
kidney
4
Q
what are the adverse effects of lithium?
A
- nausea/vomiting, diarrhoea
- fine tremor
- nephrotoxicity
- thyroid enlargement
- weight gain
- idiopathic intracranial hypertension
- leucocytosis
- hyperparathryoidism –> hypercalcaemia
5
Q
what ECG changes can be seen with a patient on lithium?
A
T wave flattening/inversion
6
Q
when should a sample for lithium levels be taken?
A
12 hours post-dose
7
Q
when are lithium levels checked?
A
- beginning = weekly
- after each dose change
- stable = 3 months
8
Q
when are thyroid and renal functions checked in a patient on lithium?
A
every 6 months
9
Q
what concentration leads to lithium toxicity?
A
> 1.5 mmol/L
10
Q
what can precipitate lithium toxicity?
A
- dehydration
- renal failure
- drugs
11
Q
what drugs can precipitate lithium toxicity?
A
- thiazides
- ACEi/angiotensin II receptor blockers
- NSAIDs
- metronidazole
12
Q
what are the features of lithium toxicity?
A
- coarse tremor
- hyperreflexia
- acute confusion
- polyuria
- seizure
- coma
13
Q
is fine tremor a sign of lithium toxicity?
A
no it is seen in therapeutic levels
14
Q
how is lithium toxicity managed?
A
- volume resuscitation with normal saline
- severe = haemodialysis
- sodium bicarbonate
