Lithium

Question 1

MOA

Answer 1

not established; maybe inhibition of phosphoinositol cascade

Question 2

Clinical

Answer 2

Mood stabilizer for bipolar:
Blocks and relapse and acute manic event

SIADH

Question 3

Toxicity

Answer 3

Tremor, sedation, edema
Heart block
Hypothyroidism
Polyuria (ADH antagonist, causes nephrogenic DI)
Teratogenic

Narrow therapeutic window, require serum level monitoring.

Question 4

Fetal toxicity of lithium

Answer 4

Fetal cardiac defects:

Ebstein anomaly and malformation of the great vessels

Question 5

Metabolism

Answer 5

Almost exclusively excreted by the kidneys;

Most is reabsorbed at the proximal convoluted tubule following the Na reabsorption.

Question 6

Lithium side effect mneumonic

Answer 6

LMNOP

Lithium side effects;
Movement (tremor)
Nephrogenic DI
hypOthyroidism
Pregnancy problems