Lithium

Question 1

Name 3 adverse effects of lithium

Answer 1

• Nausea/vomiting, diarrhoea
• Fine tremor
• GI disturbance
• Dry mouth and increased thirst
• Polyuria secondary to nephrogenic diabetes insipidus
• Thyroid enlargement which may lead to hypothyroidism
• ECG: T wave flattening/inversion
• Weight gain
• Idiopathic intracranial hypertension
• Leucocytosis
• Hyperparathyroidism and subsequent hypercalcaemia

Question 2

1) After starting lithium levels should be performed how often until concentrations are stable?
2) Once concentrations are established, how often should lithium levels be checked?
3) Which 2 tests should be done every 6 months in a patient on lithium?

Answer 2

1) Weekly
2) Every 3 months
3) Liver function tests and thyroid function tests

Question 3

Name 2 clinical features of lithium toxicity

Answer 3

• Coarse tremor
• CNS disturbance including seizures, impaired co-ordination, dysarthria
• Arrhythmias
• Visual disturbance

Question 4

Name 2 aspects of the management of lithium toxicity

Answer 4

• Maintaining electrolyte balance
• Monitoring renal function
• Seizure control