lithium

Question 1

what

Answer 1

mood stabiliser

used for bipolar disorder

Question 2

therapeutic range

Answer 2

0.4-1 mmol/L

Question 3

side effects

Answer 3

fine tremor
dry mouth 
GI upset
increased thirst 
inc urination 
hypothyroidism 
hyperparathyroidism 
nephrotoxicity

Question 4

Monitoring - when should lithium levels be checked

Answer 4

12hrs post dose
one week after starting treatment 
one week after dose change 
weekly until levels stable 
3 monthly once levels stable

Question 5

what should be monitored every 6mo

Answer 5

BMI
U&Es, eGFR
calcium
TFTs

Question 6

clinical features of lithium toxicity

Answer 6

coarse tremor
seizure
lack coordination
dysarthria 
arrythmias
visual disturbance
hyperreflexia

Question 7

lithium toxicity - what serum levels

Answer 7

1.5mmol and above

severe if ~2+

Question 8

ECG changes

Answer 8

T wave flattening/inversion