lithium, benzos, Z drugs Flashcards

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1
Q

GI SE lithium

A

N+V+D

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2
Q

nephrotoxic SE lithium

A

polyuria, diabetes insipidus

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3
Q

neuro SE lithium

A

fine tremor, idiopathic intracranial hypertension

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4
Q

endocrine SE lithium

A

hypothyroid // hyperparathyroid –> hypercalcaemia

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5
Q

ECG + FBC changes lithium

A

ECG = flattened T wave // leucocytosis (raised WBC)

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6
Q

therapeutic index lithium

A

v narrow

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7
Q

when should lithium samples be taken

A

12 hours post dose

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8
Q

how often do lithium levels need to be checked

A

starting or a change in dose = weekly until stable level, then every 3 months

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9
Q

how often does kidney + thyroid function need to be checked lithium

A

6 months

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10
Q

when does lithium toxicity occur

A

> 1.5 mmol/L

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11
Q

what can precipitate toxicity to lithium

A

dehydration // renal failure // meds

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12
Q

what meds can precipitate toxicity to lithium

A

diuretics (thiazides) // ACEi , ARBs // NSAIDs // metronidazole

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13
Q

symptoms lithium toxicity

A

coarse tremor (as opposed to fine) // hyprereflex // polyuria // confusion, seizure

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14
Q

mx lithium toxicity

A

mild = saline // severe = haemdialysis

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15
Q

mechanism benzo

A

enhance GABA (the inhibitory neurotransmittor) –> increased frequency of chloride channels

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16
Q

indication benzos

A

sedation // hypotic // anxiety // anticonvulsant // muscle relaxant

17
Q

how long should benzos be prescribed for

A

2-4 weeks

18
Q

how to withdraw benzos

A

switch to diazepam // reduce every 2-3 weeks by 2-2.5mg

19
Q

symptoms of too quick withdrawal benzos

A

insomnia, irritable, anxious, tremor, tinnitus, perception altered, loss of appetite

20
Q

mechanism of benzo vs barbiturates

A

benzos increase frequency chloride channel // barbiturates increase duration chloride channel

21
Q

mechanism of Z drugs

A

V similar to benzo // act on a2 GABA subunit

22
Q

indication Z drugs

A

mainly insomnia

23
Q

examples Z drugs

A

zopiclone, zaleplon