Mental Health Flashcards
When do symptoms of lithium toxicity occur
Between 1.5 to 2meq/l
Symptoms of mild lithium toxicity
Lithium level is 1.5
Apathy Lethargy Diminished concentration Mild ataxia Coarse hand tremors Slight muscle weakness
Symptoms of moderate lithium toxicity
Lithium level is between 1.5 and 2.5 Nausea and vomiting Severe diarrhea Mild to moderate ataxia and incoordination Slurred speech Tinnitus Blurred vision Muscle twitching Irregular tremor
Symptoms of severe lithium toxicity
Greater than 2.5 serum level
Nystagmus Muscle fasiculations DT hyperreflexia Visual or tactile hallucinations Oliguria or Anuria Impaired LOC tonic clonic seizures or coma leading to death
What is bipolar disorder
Characterized by episodes of mania and depression with periods of normal mood and activity in between
How is bipolar normally treated
Traditionally lithium carbonate which can be toxic
For this you need stable amount of sodium and fluid (2-3L) daily to avoid toxicity
Others
-valproic acid
-carbamazepine to reduce acute
For maintenance therapy: lamotrigine
What other class of medication can assist with bipolar
Anti-anxieties for psychomotor agitation characterized with mania
Although should be avoided in those with a substance abuse issue
Atypicals - olanzepine and aripiprazole and risperidone for their sedative and mood stabilizing effects
Assessment of mania with bipolar
Angry quick Delusional self confidence Constantly pushing limits Euphoric with intense feelings of well being Little to no inhibition Distracted by environmental stimuli Extroverted personality Gradiose and percusatory delusions High and unstable affect Inability to eat or sleep due to more important things Unlimited energy Inappropriate affect Dress that is inappropriate Make up colourful and ovedone Initiation of activity Pressured or clanged speech Restlessness Sexually promiscuous Urgent motor activity
Assessment with depression
Increased or decreased appetite Decreased activities of daily living Decreased emotion or physical activity Easily fatigued Inability to make decisions Poor concentration Internalizing hostility Introverted personality Social isolation Lack of energy Lack of initiative Lack of confidence and self esteem Lack of sexual interest Psychomotor retardation Suicidal ideation.
What is rotavirus
Serious gastroenteritis and is hospital acquired pathogen
Most severe in children 3-24 months
Children younger than 3 months have some protection from mother antibodies
Define lithium toxicity
When the lithium cannot be detoxified and excreted by the kidneys
