Drug Class:

Lithium

Prototype (Generic/Trade): Eskalith, Lithobid

Medications in this Class:

Eskalith, Lithobid
Mechanism of Action/Drug Effects:
Specific mechanism unknown; alters sodium transport in nerve and muscle cells and effects shift toward intraneuronal metabolism of
catecholamines.
Indications:
Management of bipolar disorder and manic episodes of manic-depressive illness.
Contraindications:
History of leukemia.
Adverse Effects:
Cardiovascular: Arrhythmias; hypotension; bradycardia; peripheral circulatory collapse. CNS: Tremor; muscle hyperirritability; headache; fatigue;
ataxia; dizziness; psychomotor retardation; confusion; dystonia; hallucinations; blackouts; seizures; pseudotumor; drowsiness; poor memory and
intellectual function; muscular weakness; slurred speech. Dermatologic Drying or thinning hair; dry skin; pruritus; exacerbation of psoriasis; acne.
EENT Blurred vision; tinnitus. GI Anorexia; nausea; vomiting; diarrhea; sialorrhea; dry mouth; parotitis. Genitourinary: Urinary urgency; stress
incontinence; polyuria; albuminuria; sexual dysfunction; symptoms of nephrogenic diabetes; decreased CrCl. Hematologic Leukocytosis; leukemia.
Metabolic Hypothyroidism; hypercalcemia; hyperparathyroidism; hyponatremia; dehydration; weight gain. Miscellaneous Taste distortion; thirst;
fever; swollen joints.
Interactions:
Adults PO 900 to 1800 mg/day in 2 to 4divided doses. Give regular capsules 3 or 4 times daily; slow-release tablets 2 or 3 times daily. Max dose,
2,400mg/day. Children 12 yr of age and older 15 to 20mg/kg/day in 2 to 3 divided doses.
Dosages:
Adults PO 900 to 1800 mg/day in 2 to 4divided doses. Give regular capsules 3 or 4 times daily; slow-release tablets 2 or 3 times daily. Max dose,
2,400mg/day. Children 12 yr of age and older 15 to 20mg/kg/day in 2 to 3 divided doses.
Nursing Considerations:
Explain that therapeutic improvement will be noted in 1 to 3 wk. Instruct patient to take medication regularly even if feeling well. Symptoms may
return if medication is discontinued. Advise patient not to decrease or increase dietary sodium intake. Tell patient to drink 8 to 10 glasses of
water or other caffeine-free liquids daily. Caution patient to avoid excessive caffeine intake, as caffeine may increase urinary excretion of
drug.Advise patient that thirst, frequent polyuria, taste distortion, and fine hand tremors are common adverse reactions. Instruct patient to
report the following symptoms to health care provider immediately: nausea, vomiting, diarrhea, muscular weakness, ataxia, blurred vision or
tinnitus .Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness
.Emphasize need for serum lithium level monitoring every 1 or 2 mo or as advised by health care provider .Encourage patient to wear medical
identification (eg, card, bracelet) at all times stating medication name and dosage.