Sketchy Pharm: Lithium

Question 1

Lithium has a __________ therapeutic window.

Answer 1

narrow (just like the “narrow window” to deboard the chair lift)

Question 2

The acute side effects of lithium include ____________.

Answer 2

nausea and vomiting (the guy almost at the end of the lift)

Question 3

The chronic side effects of lithium include ______________.

Answer 3

tremor and ataxia (like the skiers who stayed on the chair lift too long); hypothyroidism (represented by the penguin with the untied bowtie –symbolizing the bowtie-shaped thyroid –and the hefty, bald snowboarder); nephrogenic diabetes (kidney damage, represented by the fountain)

Question 4

Be careful prescribing _____________ to patients taking lithium.

Answer 4

thiazides and NSAIDs –both of which lower GFR and decrease lithium clearance (think of the pasty thighs of the diver over the Low Clearance chair lifts)

Question 5

When given to pregnant women, lithium can cause __________________.

Answer 5

Ebstein’s anomaly (ASD, hypoplastic right ventricle, and failure of the tricuspid valve to develop)

Question 6

Antiepileptics such as ______________ can be given to help stabilize those with bipolar disorder.

Answer 6

valproic acid (winter festiVAL), carbamazepine (classic CAR), and lamotrigine (lLAMa costume on kid)

Question 7

Acute mania is usually treated with _______________.

Answer 7

first- or second-generation antipsychotics (think of the PEAK of mania)