Lithium Flashcards
First medical therapy of bipolar disorder
-Narrow therapeutic index
Lithium
Inhibits inositol monophosphate (IMPase)
Lithium
Used to regenerate inositol which decreases intracellular 2nd messenger levels
Lithium
Eliminated primarily by renal excretion
Lithium
Lithium is mostly reabsorbed by the
-just like Na+
Proximal Tubule
Lithium toxicity can cause
Renal insufficiency and volume depletion
Thiazides diuretics, NSAIDs, and ACE inhibitors all increase
Lithium levels
What causes decreased lithium levels?
Potassium-sparing diuretics
A classic exam of a drug that increases lithium and may cause toxicity is
Thiazides diuretics
Has the long term effect of hypothyroidism, nephrogenic diabetes insipidus, and cardic issues
Lithium
In the fetus, lithium can cause
Ebstein’s anomaly
Most common symptoms of lithium toxicity
-Usually limited to hands or arms
Tremor
Classified as a goitrogen. Meaning it inhibits hormone release and commonly causes Goiter
-May cause hypothyroidism
Lithium
Lithium can cause “chronic tubulointerstitial nephropathy” which is the loss of tubule urine concentrating ability. In other words, the tubules do not respond to
ADH
This lack of response to ADH leads to
-Polyuria and polydipsia
Diabetes Insipidus
