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
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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
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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
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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)
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