Mood stabalisers Flashcards
4 indications for lithium
1) prophylaxis for bipolar
2) manage manic episodes
3) prophylaxis in recurrent depression
4) prophylaxis in schizoaffective disorder
Onset of lithium
7-14 days
Baseline tests for lithium (8)
Weight, BP, pulse Renal function FBC U&E TFT Base line ECG
Check for what in the neck before starting lithium?
goitre
4 important drug interactions with lithium
ACE
Diuretics
NSAIDS
SSRIs
4 contraindications for lithium
1) Cardiac disease
2) Significant renal impairment
3) Addison’s disease
4) Untreated hypoT
In which stage of pregnancy should lithium be avoided?
1st
Lithium - very important point in terms of prescribing
prescribe by brand
Important advice on medication for patients on lithuium (interaction)
don’t take with NSAIDs
Alcohol advice with lithium
1-2 units p/day max
How long does it take to establish on lithium?
3-6 months
Blood levels checked?
@12hrs
@ 5 days
then weekly until 4 weeks stable
then every 3 months
6 SE of lithium
Abdo pain Nausea Metallic taste (usually wears off) Fine tremor Thirst and polyuria Weight gain and oedema
Advice on withdrawal
Don’t stop suddenly
Sodium valproate pre questions
Pregnant / trying for a baby / breast feeding?
Liver or kidney problems?
What should SV be taken with?
after meals
No. of doses per day for SV
2-3 tablets
Alcohol and SV
none
Medication to avoid with SV
aspirin
SE of SV (8)
Nausea Stomach ache Diarrhoea Headache Increased appetite and Weight gain Feeling tired Hair thinning
Regular blood checks for what when on SV?
Liver
How long is SV taken in bipolar?
usually life long
Lithium toxicity effects two systems
GI and Neuromuscular
Lithium GI toxicity presents as?
anorexia, diarrhoea and vomiting
Lithium neuromuscular toxicity presents as?
Dysarthria, dizziness, ataxia, muscle twitches, tremor and co-ordination problems.
