Lithium Toxicity Flashcards
What type of drug is lithium?
mood stabiliser
when is lithium indicated?
BAD AND MANAGEMENT OF ACUTE MANIC AN DHYPOMANIC EPISODES, it also can augment antidepressant effect
which drugs does lithium interact with?
ACE inhibitors
diuretics
NSAIds
SSRIs
what are contraindications to lithium prescription?
cardiac disease
significant renal impairment
Addisons disease
untreated hypothyroidism
what are the therapeutic levels of lithium?
0.4-1.0 mol/L
how often do you check lithium levels?
every three months and during any illness
What are common side effects of lithium?
- Abdominal pain
- Nausea
- Metallic taste in mouth (usually wears off)
- Fine tremor
- Thirst, polyuria, impaired urinary concentration
- Weight gain and oedema
What is the toxic level of lithium?
> 1.5 mmol/L
what level of lithium is associated with serious toxicity?
> 2.0 mmol/L
When should lithium toxicity be expected but the lithium level is within therapeutic range?
when patient is symptomatic
Lithium Toxicity more commonly occurs due to chronic treatment, this can be due to…
• Dehydration • Worsening renal function • Concurrent infections • Drug interactions Can also get lithium toxicity when the patient is not eating and drinking, and so makes lithium more concentrated in the body i.e. when the patient is ill
What is the most common cause of lithium toxicity?
Chronic use
Symptoms of lithium toxicity?
- Anorexia
- Drowsiness, apathy, restlessness
- Dysarthria (difficult or unclear articulation of speech that is otherwise linguistically normal)
- Dizziness, ataxia, incoordination, muscle twitching, coarse tremor
what are severe symptoms of lithium toxicity?
- Hyperreflexia
- Convulsions
- Collapse
- Coma
- Renal failure
- Dehydration
- Circulatory collapse
- Hypokalaemia
- Death
Mx of lithium toxicity?
Treatment is supportive but can have haemodialysis in order to reduce in blood but this is usually only indicated in someone who is renally impaired.
