Carbolith, Duralith, Eskalith, Lithobid (lithium)

Classification: mood stabilizer

Indication (Use): Manic episodes of manic depressive illness (treatment, maintenance,

prophyaxis

Normal dosage: Adult ~ PO 300-600mg PO up to qid increased on level to reach optimal

dosage usually 1800mg PO daily. REC LVL: 1-1.5 mEq/L for acute maina; 0.6 to 1.2 mEq/L for
maintenance, 2 mEq/L Max

Children <12 yr 15-20mg (0.4-0.5 mEq)/kg/day in 2-3 divided doses, doses may
be adjusted weekly.

Side Effects: CNS SEIZURES, Fatigue, h/a, ataxia, sedation, confusion, dizziness, drowsiness,
impaired memory, fatigue, psychomotor retardation, restlessness, stupor CV: ARRHYTHMIAS
ECG changes, edema, hypotension EENT: aphasia, blurred vision, dysarthria, tinnitus GI: Abd
pain, anorexia, bloating, diarrhea, nausea, dry mouth, metallic taste GU: polyuria, glycosuria,
nephrogenic diabetes insipidus, renal toxicity Derm: acneiform eruption, folliculitus, alopecia,
diminishing sensation, pruritus, ENDO: hypothyroidism, goiter, hyperglycemia,
hyperthyroidism F and E: Hyponatremia Hema: leukocytosis Metab: Weight gain MS: Muscle
weakness, hyperirritability, rigidity Neuro: Tremors

Nursing implications: Assess mental status, Orientation, mood behavior

Patient teaching: Explain the purpose of the medication, thoroughly explain possible side
effects and what adverse reaction to look for. If a dose is missed take ASAP unless the next
scheduled dose is within 2hrs. This drug may cause drowsiness so to use caution with all normal
activities to include driving, making sure the pt. understands the importance of contacting their
physician’s office if he/she experiences fainting, irregular pulse or they become SOB,; before
taking OTC or herbal medications. Schedule F/U with Primary care provider for periodic lab test
to monitor for Lithium toxicity,

Administration Principles: Admin with food or milk to minimize GI irritation.