Lithium Flashcards
1
Q
Lithium
A
- treats acute mania and maintenance treatment
2
Q
What is the onset of Lithium duration
A
- Onset 10 to 21 days → supplemented in the early phases might be needed like: second-generation antipsychotics, anticonvulsants, or antianxiety medications
3
Q
Is particularly effective in reducing the following:
A
- Elation, grandiosity, and expansiveness
- Flight of ideas
- Irritability and manipulation
- Anxiety
- Self-injurious behavior
4
Q
When do you reach therapeutic levels
A
- Reaching therapeutic levels may take 7-14 days or longer
5
Q
-What is the target range for lithium serum level(s)
A
for a 12-hour serum trough level is 0.8–1.2 mEq/L
6
Q
What is the level for acute mania?
A
- for acute mania : levels of 1.0–1.2 mEq/L
7
Q
maintenance phase:levels
A
- dose 900 to 1200 mg a day
- target serum lithium level 0.6 to 0.8 mEq/L
- 0.4 to 0.6 mEq/L—may be considered in some cases, such as adjunctive treatment for bipolar I patients or monotherapy for bipolar II patients
8
Q
Blood should be checked every
A
- 1st lithium level should be drawn every 2 to 3 days after beginning lithium therapy and after any dosage change until the therapeutic level has been reached
- Blood levels check every 3 to 6 months
9
Q
- Before administering lithium assess:
A
- renal function and thyroid status
- assess for levels of thyroxine and thyroid-stimulating hormone
- electrocardiogram as needed
10
Q
- Contraindicated patients with:
A
- cardiovascular disease
- brain damage
- renal disease
- thyroid disease
- myasthenia gravis
- Whenever possible, not given to women who are pregnant - may harm the fetus.
- Mothers who are breast-feeding
- children younger <12 years
11
Q
TABLE 13.4 Lithium Side Effects and Signs of Lithium Toxicity
Plasma Level
- less <1.5 mEq/L
Signs
A
- Nausea
- vomiting
- diarrhea
- thirst
- polyuria (producing too much urine)
- lethargy
- sedation
- fine hand tremor
- Renal toxicity
- goiter (swelling of the neck)
- hypothyroidism with long-term use
12
Q
Plasma Level
- less <1.5 mEq/L
Interventions
A
- Symptoms subside during treatment
- Doses should be kept low
- Kidney function and thyroid levels should be assessed before treatment
- Kidney function and thyroid levels annual assessment
13
Q
- Early Signs of Toxicity
Plasma Level
A
- 1.5–2.0 mEq/L
14
Q
Plasma Level
- 1.5–2.0 mEq/L
Signs
A
- GI upset
- coarse hand tremor
- confusion
- hyperirritability of muscles
- electroencephalographic changes
- sedation
- incoordination
15
Q
Plasma Level
- 1.5–2.0 mEq/L
Interventions
A
- Medication should be withheld
- blood lithium levels measured
- dosage reevaluated
