Lithium: Difference between revisions
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# | ==Administration== | ||
*Type: Anti[[bipolar disorder|manic]] 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== | |||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D | |||
*[[Lactation risk categories|Lactation risk]]: infant risk cannot be ruled out | |||
===Renal Dosing=== | |||
*Adult: Contraindicated if renal function unstable<ref>https://reference.medscape.com/drug/eskalith-lithobid-lithium-342934#5</ref> | |||
===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<ref>https://reference.medscape.com/drug/eskalith-lithobid-lithium-342934#5</ref> | |||
==Comments== | |||
==See Also== | |||
*[[Lithium toxicity]] | |||
==References== | |||
<references/> | |||
[[Category:Pharmacology]] | |||
[[Category:Psychiatry]] | |||
Latest revision as of 22:56, 22 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]