Lithium counselling Flashcards
1
Q
Check for contraindications
A
- 1st trimester pregnancy
- Breast-feeding
- Cardiac insufficiency/ rhythm disorder
- Significant renal impairment
- Addison’s disease
- Low sodium diets
- Untreated hypothyroidism
2
Q
How the treatment works
A
- Mood stabiliser
- Exact mechanism unknown
- Thought to interfere with neurotransmitter release and receptors
- Treatment course and how it’s taken
- Once or twice daily tablet/liquid
- Taken long-term if effective
- Takes 1-2 weeks to work
3
Q
Monitoring required
A
- Before starting - FBC, U&Es, TFTs, Beta-HCG, ECG
- Check lithium level after 5 days, then every week until stable for 4 weeks, then every 3 months
- Check TFTs, U&Es, Ca2+ every 6 months
4
Q
Side effects
A
- GI (abdominal pain, nausea)
- Metallic taste
- Fine tremor
- Water symptoms (thirst, polyuria, impaired urinary concentration, weight gain and oedema)
- Renal toxicity
- Nephrogenic diabetes insipidus
- Hypothyroidism
- Lithium toxicity symptoms GI(anorexia, diarrhoea, vomiting)
- Neuromuscular (dysarthria, dizziness, ataxia, impaired co-ordination, muscle twitching, tremor)
- Others (drowsiness, apathy, restlessness)