Lithium: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: Anti[[bipolar disorder|manic]] agent | ||
*Dosage Forms: | *Dosage Forms: | ||
*Routes of Administration: oral | *Routes of Administration: oral | ||
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*[[Lactation risk categories|Lactation risk]]: infant risk cannot be ruled out | *[[Lactation risk categories|Lactation risk]]: infant risk cannot be ruled out | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: Contraindicated if renal function unstable<ref>https://reference.medscape.com/drug/eskalith-lithobid-lithium-342934#5</ref> | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
*Adult: | *Adult: Not established | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
* | *Unstable renal function | ||
*Severe dehydration | |||
*Sodium depletion | |||
*Severe debilitation | |||
*Concurrent diuretics | |||
*Severe cardiovascular disease | |||
*1st trimester pregnancy | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
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===Common=== | ===Common=== | ||
* | *Hypothyroidism, weight gain | ||
*Nephrotoxicity | *Nephrotoxicity | ||
*Fine tremor, hyperreflexia | *Fine tremor, hyperreflexia | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Exact mechanism unclear; inhibits postsynaptic D2 receptor supersensitivity, alters cation transport in nerve cells, influences serotonin/norepinephrine reuptake, inhibits phosphatidylinositol cycle second messenger systems<ref>https://reference.medscape.com/drug/eskalith-lithobid-lithium-342934#5</ref> | |||
==Comments== | ==Comments== | ||
Revision as of 16:29, 19 September 2019
Administration
- Type: Antimanic agent
- Dosage Forms:
- Routes of Administration: oral
- Common Trade Names:
Adult Dosing
- Maintenance: 300mg PO 3 to 4 times daily; desired serum lithium level 0.6 to 1.2 mEq/L
- Acute manic episode: 600mg PO 3 times daily; desired serum lithium level 1 to 1.5 mEq/L
Pediatric Dosing
Safety/efficacy not established in children <12yo
Special Populations
- Pregnancy Rating: D
- Lactation risk: infant risk cannot be ruled out
Renal Dosing
- Adult: Contraindicated if renal function unstable[1]
Hepatic Dosing
- Adult: Not established
Contraindications
- Allergy to class/drug
- Unstable renal function
- Severe dehydration
- Sodium depletion
- Severe debilitation
- Concurrent diuretics
- Severe cardiovascular disease
- 1st trimester pregnancy
Adverse Reactions
Serious
- Toxicity (see Lithium toxicity)
- Seizure, ataxia, raised ICP
- Angioedema
- Erythema multiforme
Common
- Hypothyroidism, weight gain
- Nephrotoxicity
- Fine tremor, hyperreflexia
- Leukocytosis
- Nausea, gastritis
- Acne
Pharmacology
- Half-life: 14-50hr
- Metabolism: Renal
- Excretion: Renal
Mechanism of Action
- Exact mechanism unclear; inhibits postsynaptic D2 receptor supersensitivity, alters cation transport in nerve cells, influences serotonin/norepinephrine reuptake, inhibits phosphatidylinositol cycle second messenger systems[2]