Lithium Flashcards
1
Q
What contraindications should be excluded before prescribing lithium?
A
- 1st trimester pregnancy
- Breastfeeding
- Cardiac insufficiency/rhythm disorder
- Significant renal impairment
- Addison’s disease
- Low sodium diets
- Untreated hypothyroidism
2
Q
How would you explain the MOA of lithium to a patient?
A
- Mood stabiliser
- Exact mechanism is unknown
- Thought to interfere with neurotransmitter release and receptors
3
Q
How should lithium be taken?
A
- Once or twice daily tablet/liquid
- Taken long-term if effective
- Takes 1-2 weeks to work
4
Q
What monitoring is required before prescribing lithium and during treatment?
A
Before:
- FBC, U&Es, TFTs, beta-HCG, ECG
During:
- Check lithium level after 5 days, then every week until stable for 4 weeks, then every 3 months
- Check TFTs, U&Es, and Ca2+ every 6 months
5
Q
What important side effects of lithium should patients be made aware of?
A
- GI (abdominal pain, nausea)
- Metallic taste
- Fine tremor
- Water symptoms (thirst, polyuria, impaired urinary concentration, weight gain, oedema)
- Renal toxicity
- Nephrogenic diabetes insipidus
- Hypothyroidism
- Lithium toxicity
6
Q
What are the signs of lithium toxicity?
A
- Dysarthria
- Ataxia
- Impaired coordination
- Muscle twitching
- Tremor
