Lithium

Question 1

What is the therapeutic range for lithium

Answer 1

0.4 mmol/L to 1 mmol/L - For prophylactic treatment and elderly

0.8 mmol/L to 1mmol/L - For Acute manic episodes & patients who have previously relapsed or have subsyndromal symptoms

Question 2

When should blood samples for lithium be taken

Answer 2

12 hours post dose

Question 3

When should bloods be monitored for lithium

Answer 3

3 months

Question 4

What are the signs of lithium toxicity

Answer 4

Renal disturbances
Extrapyramidal side effects
Visual disturbances
Nervous system disturbances
Gastro effects

Question 5

what does a plasma lithium level of >2 mmol/L indicate

Answer 5

Renal failure, seizures, arrhythmias, coma

Question 6

Why should lithium be prescribed by brand

Answer 6

Lithium carbonate and lithium citrate
Different preparations vary in bioavailability

Question 7

What are the side effects of lithium

Answer 7

Thyroid disorders - hypo/hyper thyroidism
Renal impairment - nephrotoxic
Benign intracranial HTN - report persistant headaches
QT prolongation
Lowers seizure threshold
Hyponatraemia - can result in lithium toxicity

Question 8

Can lithium be given in pregnancy and breastfeeding

Answer 8

No teratogenic
Toxicity can occur in BF infants