Lithium

Question 1

unique fact?

Answer 1

only med to decrease suicide rate

Question 2

indications?

Answer 2

long-term prophylaxis for mania/ depressive sx in BAD

Question 3

name 3 factors which indicate a +ve repsonse?

Answer 3

previous long term response/ fam member with good response, classic pure mania, mania followed by depression

Question 4

before starting?

Answer 4

baseline U+Es, TSH, pregnancy test

Question 5

why does pregnancy test always need to be done?

Answer 5

lithium can cause Ebstein’s anomaly in 1st trimester

Question 6

monitoring?

Answer 6

steady state after 5 days - check 12hrs after last dose - also check TSH and Creatinine @ 3 and 6 months

Question 7

goal level?

Answer 7

0.6 - 1.2

Question 8

name 4 SEs?

Answer 8

GI distress, thyroid sx, leukocytosis, fibrosis

Question 9

3 levels of toxicity?

Answer 9

mild, moderate, severe

Question 10

level of lithium - mild toxicity?

Answer 10

1.5-2.0

Question 11

level of lithium - moderate toxicity?

Answer 11

2.0-2.5

Question 12

level of lithium - severe toxicity?

Answer 12

> 2.5

Question 13

how does mild toxicity present?

Answer 13

Vomiting, diarrhoea, slurred speech, nystagmus, etc.

Question 14

how does moderate toxicity present?

Answer 14

N+V, anorexia, blurred vision, clonic limbs etc.

Question 15

how does severe toxicity present?

Answer 15

generalised convulsions, oliguria, renal failure