Lithium Carbonate Patient Teaching

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Questions and Answers

What lifestyle adjustment should a patient on Lithium maintain to prevent toxicity?

Increase protein intake

Limit fluid intake to 1 quart/day

Eat a normal diet with normal salt intake (correct)

Avoid dehydration by drinking only caffeine-free beverages

Which of the following symptoms is associated with Grade 1 Lithium toxicity?

Rigidity

Hyperreflexia (correct)

Stupor

Coma

What is the appropriate treatment for Grade 3 Lithium toxicity?

Hemodialysis (correct)

Increased fluid intake

Hydration

Kayexalate

What is a contraindication for Lithium therapy?

Active dehydration Signup and view all the answers

Which sign or symptom should a patient report to their healthcare provider that is a possible indication of Lithium toxicity?

Diarrhea or fever Signup and view all the answers

How should extended-release Lithium tablets be taken?

Swallowed whole without chewing Signup and view all the answers

Why is it important for Lithium patients to keep frequent check-ups?

To ensure effective toxicity management Signup and view all the answers

What might be a common side effect experienced by a patient taking Lithium?

Greater than usual urine volume Signup and view all the answers

What is the usual maintenance dose range for lithium?

900-1,200 mg/day Signup and view all the answers

What is a common side effect of lithium that may occur in patients?

Increased thirst Signup and view all the answers

Which of the following is a method to monitor toxicity in patients taking lithium?

Therapeutic serum levels measurement Signup and view all the answers

Which condition is NOT a sign of lithium toxicity?

Leukocytosis Signup and view all the answers

What is the unknown mechanism thought to be responsible for lithium's action in the CNS?

Decreases dopamine and norepinephrine release, increases serotonin synthesis Signup and view all the answers

What is the initial dose range for lithium typically when starting therapy?

600-900 mg/day Signup and view all the answers

Which of the following indicates the use of lithium?

Bipolar disease and mania Signup and view all the answers

What are the potential drug-drug interactions that require close monitoring during lithium therapy?

Caffeine and NSAIDs Signup and view all the answers

Study Notes

Lithium Carbonate: Pt Teaching

Take the medication exactly as prescribed, with meals or food/milk. Do not chew or crush extended-release tablets.
Maintain a normal diet and adequate fluid intake (at least 2.5 quarts/day).
Arrange for frequent checkups, including blood tests.
Discontinue the medication and notify the healthcare provider if toxicity symptoms occur (diarrhea, vomiting, ataxia, tremor, drowsiness, lack of coordination, muscular weakness).

Lithium Carbonate: Side Effects

Possible Side Effects: drowsiness, dizziness (avoid driving or tasks requiring alertness), GI upset (eat small, frequent meals), mild thirst, increased urine output, fine hand tremor (report severe tremor to doctor).
Report diarrhea and fever.
Drug interactions: ACE inhibitors, thiazide diuretics, carbamazepine, NSAIDs, methyldopa, fluoxetine.
Food interactions: caffeine (natural diuretic), maintain normal sodium intake.

Lithium Carbonate: Toxicity Grades & Management

Grade 1 (1.5-2.5 mEq/L): Nausea, vomiting, tremors, hyperreflexia, ataxia, muscular weakness. Treatment: hydration every 4-6 hours, Kayexalate.
Grade 2 (2.5-3.5 mEq/L): Hypertonia, hypotension, rigidity, stupor. Treatment: hydration, Kayexalate, dialysis.
Grade 3 (>3.5 mEq/L): Coma and seizures. Treatment: hemodialysis.

Lithium Carbonate: Contraindications

Hypersensitivity
Cardiac and renal disease
Dehydration and sodium depletion
Brain damage
Pregnancy and lactation

Lithium Carbonate: Black Box Warning

Monitor clinical status closely, especially during the initial stages of therapy (twice per week).
Monitor maintenance doses monthly.
Monitor therapeutic serum levels (0.6-1.2 mEq/L).
Toxicity is closely related to serum levels.

Lithium Dosage and Side Effects (Page 2)

Initial dose: Typically 600-900 mg/day, divided into 2-3 doses.
Maintenance dose: Generally 900-1200 mg/day, divided into 2-3 doses.
Acute Mania/Severe Cases: May start higher (1800-2400 mg/day).
Toxicity: Occurs when lithium levels exceed 1.5 mEq/L. Factors contributing to toxicity: fluid loss, dehydration, hyponatremia, decreased renal function, NSAIDs, thiazide diuretics, ACE inhibitors, antipsychotics, fluoxetine.

Lithium Carbonate: Classification and Action (Page 2)

Mechanism of action unknown, thought to work in the CNS affecting neurotransmitter release. Decreases dopamine and norepinephrine, increases serotonin.
Used to treat bipolar disorder, mania, hypomania, recurrent/severe depression.
Used to treat symptoms of mania (high energy, happiness, lack of sleep, euphoric behavior).

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Description

This quiz focuses on essential patient education regarding lithium carbonate, including proper medication administration, side effects, and toxicity management. It covers critical information such as dietary recommendations and the importance of regular checkups. Understanding these aspects is crucial for safe and effective treatment.