NAME OF THE DRUG

GENERIC NAME:
Lithium Carbonate

BRAND NAME:
Eskalith
CLASSIFICATION
CNS agent;
Psychotherapeutic
agent; Antimanic
DOSAGE:
450 mg 1 tab
ROUTE:
Oral, OD

MECHANISM OF
ACTION
The
lithium
ion
behaves in the body
much like the sodium
ion; but its exact
mechanism of action
is unclear. Competes
with
various
physiologically
important
cations:
Na+, K+, Ca++, Mg+
+; therefore, it affects
cell membranes, body
water,
and
neurotransmitters. At
the
synapse,
it
accelerates
catecholamine
destruction,
inhibits
the
release
of
neurotransmitters and
decreases sensitivity
of
postsynaptic
receptors.
Inhibits
neurotransmitters;
decreases over-activity
of receptors involved
in stimulating manic
states.
Response
evidenced by changed
facial affect, improved
posture, assumption of
self-care,
improved
ability to concentrate,
improved
sleep
pattern.

INDICATION

CONTRAINDICATION

SIDE EFFECTS

Restlessness
Loss of appetite
Weight gain or weight
loss

Stomach pain, gas,

constipation, or
indigestion

Mild thirst

Dry mouth

The medicine is also

used
to
treat
depression,
schizophrenia, eating
disorders, impulse
control
disorders,
and certain mental
illnesses in kids.

Excessive saliva in
mouth

Change in the ability

to taste food

Swollen lips

It's sometimes used

to treat alcoholism,
headaches,
epilepsy, diabetes,
liver disease, kidney
disorders, arthritis,
asthma,
an
overactive thyroid,
Huntington's
disease,
herpes,
Tourette's syndrome,
Meniere's disease,
and other conditions.

Acne

Hair loss

Extreme discomfort in
cold temperatures

Depression

Muscle or joint pain

Itching or rash

Thin, brittle
fingernails or hair

Lithium
is
a
medication
commonly used to
treat and prevent
mania episodes in
people with bipolar
disorder. Mania is
abnormal
excitement, which
may
lead
to
undesirable
behaviors.

Older adults; thyroid disease;

epilepsy; concomitant use
with haloperidol and other
antipsychotics;
parkinsonism; diabetes
mellitus; severe infections;
urinary retention.

NURSING
RESPONSIBILITIES
Monitor response to
drug. Usual lag of 12
wk precedes response
to lithium therapy.
Keep
physician
informed of progress.
Monitor lithium level:
Generally
dosage
regimen is designed to
maintain
serum
lithium levels of 1.0
1.5 mEq/L in acute
mania and 0.61.6
mEq/L
during
maintenance
treatment;
blood
sample to determine
serum lithium level is
drawn prior to next
dose (812 h after last
dose) when lithium
level is fairly stable.
Monitor for S&S of
lithium toxicity, often
when lithium levels
are 1.52.0 mEq/L
(e.g.,
vomiting,
diarrhea,
lack
of
coordination,
drowsiness, muscular
weakness,
slurred
speech). Withhold one
dose
and
call
physician.
Drug
should not be stopped
abruptly.
When lithium levels
are above 2.0 mEq/L,
symptoms
may
include ataxia, blurred
vision,
giddiness,
tinnitus,
muscle

Hand movements that

are difficult to control

twitching or coarse
tremors, and a large
output of dilute urine.
Weigh patient daily;
check ankles, tibiae,
and wrists for edema.
Report changes in
I&O ratio, sudden
weight gain, or edema.
Polydipsia
and
polyuria, apparently
not dose-related, are
common early adverse
effects, particularly in
older
adults.
Symptoms may lessen
but reappear after
several months or even
years of maintenance.
Report early signs of
extrapyramidal
reactions promptly to
physician.
The
encephalopathic
syndrome may be
induced when lithium
is given concomitantly
with haloperidol or
with
other
antipsychotic
medication,
particularly in older
adults.
Keep
physician
informed
of
all
presenting S&S. The
fine tremor of hand or
jaw, polyuria, mild
thirst, transient mild
nausea, and general
discomfort that may
occur
in
early
treatment of mania
sometimes
persist

throughout
therapy.
Usually,
however,
symptoms
subside
with
temporary
reduction of dose. If
symptoms
persist,
drug is withdrawn.
Monitor
thyroid
function periodically.
Be alert to and report
symptoms
of
hypothyroidism.
Neonates born of
mothers who took
lithium
during
pregnancy may have
high serum lithium
level manifested by
flaccidity,
poor
reflexes,
cardiac
dysrhythmia,
and
chronic twitching.
Lithane
contains
tartrazine, which may
cause an allergic-type
reaction in susceptible
patients.
Monitor older adults
carefully to prevent
toxicity, which may
occur at serum levels
ordinarily tolerated by
other patients.