Lithium Flashcards
What is the mode of action of lithium?
Inhibition of dopamine release
Enhancement of serotonin
Decreased formation of intracellular second messengers
How long does lithium take to become effective?
7 days
What are the indications for lithium us?
Prevention of depressive and manic episodes in bipolar I
Treatment of acute mania
Is lithium take with food or on an empty stomach?
With food
What are the precautions for lithium?
Hyponatraemia
Renal impairment
Serotonergic medications
Pregnancy and breastfeeding
Why is hyponatraemia a precaution for lithium use?
Increases lithium toxicity
What may cause hyponatraemia?
Vomiting, diarrhoea, diuretics, dehydration, Addison’s disease
How is lithium extreted?
Renal
Why should precaution be taken with lithium and psoriases?
Lithium may precipitate and exacerbate psoriasis.
What are teratogenic effects of lithium?
Heart defects, neurotoxicity, hypothyroidism and neuromuscular problems
During which trimester is lithium most teratogenic?
First trimester
What are the signs and symptoms of mild lithium toxicity?
Blurred vision
Diarrhoea, nausea, vomiting
Muscle weakness, ataxia
Drowsiness
What are the signs and symptoms of severe lithium toxicity?
Course tremor
Dysarthria
Increased muscle tone, hypereflexia
Disorientation, seizures, psychosis.
What are the common adverse effects of lithium?
Metallic test Gastrointestinal symptoms Weight gain Nephrotoxicity Hypothyroidism Benign T wave changes on ECG Acne, psoriasis Leukocytosis
What ECG changes may be caused by lithium?
Benign T wave changes
Arrhythmia (rare)
