Lithium Flashcards
how long until the full effect of lithium
6-12 months
lithium is contraindicated in what diet?
and it what untreated endocrine condition?
low sodium
untreated hypothyroidism
what two conditions is long term lithium therapy associated with
thyroid and memory conditions
Lithium toxicity may be worse in what electrolyte imbalance?
And therefor what drugs should be avoided
sodium depletion
diuretics (particularly thiazide like)
sypmtoms of Li overdose
GI disturbance, visual disturbance, polyuria, muscle weekness, fine - coarse tremor, CNS disturbance
More severely: seizure, cardiac arrythmias, BP changes, circulatory failure, renal failure, coma, death
when should samples for Li levels be taken
what level targets
12 hours after dose
0.4-1mmol/L
or 0.8-1 mmol/L in mania
how often to check lithium levels
3 months
2 tests to have every 6 months on Li
CrCl
LFTs
how to withdraw lithium and why?
gradually 4 weeks - 3 months or using another substitute treatment
as increase in relapse
Why should patients report persistent headache
intercranial hypertension
why should BZs not be used long term for depression
risk of dependance
what i usually first line for bipolar disorder
antipsychotics
then Li or valproate
the carbemazepine
how long should withdrawl from an antipsychotic take
4 weeks if moving to another drug
3 months if there is history of manic relapse/not moving to another drug
Main caution of valrpoate
and another also caution
liver toxicity- esp in under 3s
usually in first 6 months of therapy
also pancreatitis
what tests would be a sign that valproate should be stopped 2
LFTs - liver tox
increased prothrombin time - suggesting liver impairment too
