Lithium - gold standard

purpose

treats manic episodes

thought to alter ion transport (Na, K, Ca) in nerve and muscle cels

alter neutrotransmiter of NTs

Therapeutic Index

0.6-1.2 mEq

What labs are needed before administration? there are 6

thyroid panel/fx

BUN and SrCr to test renal fx

ECG for pt older than 40

CBC with diff

body weight, BMI, blood glucose

pregnancy test

Adverse effects?

weight gain

ECG changes - bradycardia arrhythmia

CNS - tremor, fatigue, headache, mental dullness

thyroid dysfunction

GI - nausea, vomiting, diarrhea

leukocytosis

kidney damage

Lithium Toxicity causes

decreased sodium intake

fluid and electrolyte loss

anti-inflammatory therapy

toxicity treatment

hold dose,

obtain and monitor lithium blood levels

vigorous hydration

Education

2-3 L of fluid/day

stable dosing schedule

monitor, assess adverse effects

implement healthy sleep, work, and caffeine habits

serun levels drawn 12 hours after last dose of lithium - best taken in morning