Lithium Maintence

What is one of the primary safety issues with lithium

Lithium Toxicity (NARROW therapeutic range)

What is the therapeutic range for lithium in individuals experiencing ACUTE MANIA

1.0 to 1.5 mEq/L

What is the therapeutic range for lithium in maintenance treatment

0.6 to 1.2 mEq/L

When initiating treatment, levels should be closer to

1.2 (higher end of range)

In maintenance treatment the optimum levels should be closer to

0.6 (lower end of range)

When should lithium levels be monitored after initial treatment?

once or twice a week (until dosage and serum levels are STABLE)

During maintenance therapy when should blood samples be drawn?

Monthly

Blood samples should be drawn ____ _____ after the last dose

12 hours

What are early signs of lithium toxicity (>1.2)

Vomit and diarrhea

What are later signs of lithium toxicity (>1.5)

GI (Nausea, anorexia, diarrhea)
CNS (muscle weakness, drowsiness, ataxia, tremor and muscle twitch)

Lithium toxicity at levels >2-3

Disorentation

Seizure

COMA

CV collapse

DEATH

Fluid intake

MAINTAIN intake at 2,000-3,000 mL/day

What should people taking lithium avoid?

EXCESSIVE SWEATING or fluid loss

What electrolyte imbalance are patients taking lithium at risk for?

HYPOnatremia

Signs and Symptoms of HYPOnatremia that the patient should report

N/V

HA

Muscle weakness

confusion

seizure

What organ is lithium hard on?

Kidneys