Lithium Chronic Flashcards
1
Q
Li Chronic Risk assessment
A
Consider in anyone on chronic therapy
Levels correlate poorly
2
Q
Li Chronic: Clinical Hansen & Amdisen classification
A
Grade1: Tremor, hyperreflexia, agitation, muscle weakness, ataxia
Grade 2: Stupor, rigidity, hypertonia, hypotension
Grade 3: coma, convulsion, myoclonus
GI sx not prominent
Precipitating illness
Impaired Li Excretion: Diabetes insipidus, Na depletion, dehydration, drug interactions
3
Q
Li Chronic: Drug interactions impairing Li Excretion
A
- NSAIDs
- ACE-i
- SSRI
- Thiazide diuretics
- Topiramate
4
Q
Li Chronic Mx:
A
Maximise renal Li Excretion:
- Correct hydration & Na
- Cease drugs impairing excretion
- monitor UEC, Li level, UO closely
5
Q
Li Chronic EE
A
Haemodialysis IF:
- neuro dysfunction + Li Level >2.5mmol/L
- Renal failure
Aim normal Level
Neuro Sx may persist post levels normal
