Lithium

Question 1

How does lithium work

Answer 1

May block phosphatidylinositol pathway (second messenger system) or inhibit glycogen synthase kinase3beta

Question 2

What is the cause of lithium toxicity

Answer 2

Lithium and sodium are very chemically similar so are treated the same by the kidneys. Lithium toxic if dehydrated as the body reabsorbs sodium and therefore lithium. Is caused by increased doe, dehydration, interactions and reduced salt intake

Question 3

What illness is lithium used first line in

Answer 3

Bipolar

Question 4

Side effects of lithium

Answer 4

Dry mouth/strange taste, polydipsia, tremor, hypothyroidism, hypoparathyroidism, long term reduced renal function, nephrogenic diabetes

Question 5

What are the toxic effects of lithium

Answer 5

D+V, blurred vision, ataxia/tremor, drowsiness, convulsions, coma

Question 6

How to treat lithium toxicity

Answer 6

Stop lithium, IV fluids, monitor renal function, possibly dialysis

Question 7

Give the stages and tests of lithium monitoring

Answer 7

Prior to initiation: U+Es, TFTs, ECG
During initiation: Lithium level (12 hours after last dose) and U+E
Every 6 months: TFTs (hypothyroid is treated with levothyroxine instead of stopping lithium)

Question 8

What compound is lithium usually given in the form of

Answer 8

Lithium carbonate

Question 9

Drug interactions in lithium

Answer 9

NSAIDS, ACEi, ARBs, diuretics