#he lithium ion beha$es in the bo%y much like the so%ium ion ion; but its its e&act &act mechan mechanism ism o' action action is unclear( unclear( Competes )ith $arious physiologically impo import rtan antt cati cation ons* s* Na+! ,+! Ca++! -g+ +; there'ore! it a''ects cell membranes! bo%y )ater! an% neurotransm neurotransmitter itters( s( At the synapse! it accelerates catecholamine %estru %estructi ction! on! inhibi inhibits ts the release o' neurotransm neurotransmitter itterss an% %ecrea %ecreases ses sensit sensiti$i i$ity ty o' postsynaptic receptors( .nhibits neurotransmitters; %ecreases o$er/acti$ity o' receptors receptors in$ol$e% in$ol$e% in stimulatin stimulating g manic stat states es(( esp espo onse nse e$i%ence% by change% 'acial a''ect! impro$e% posture! assumption o' sel'/c sel'/care! are! impro$ impro$e% e% ability ability to concentrate! concentrate! impro$e% sleep pattern(
RESPONSIBILITIES
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Lithium is a me%ication common commonly ly use% use% to trea treatt an% an% pre$ pre$en entt mani maniaa epis episo% o%es es in people )ith bipolar )ith bipolar %isor%er ( -ani -aniaa is abnormal e&cite e&citemen ment! t! )hich )hich may lea% to un%esirable beha$iors( #he me%icine is also use% to treat %epression! schiophrenia! eating %isor %isor%er %ers! s! impuls impulsee contro controll %isor% %isor%ers ers!! an% certai certain n mental mental illnesses in ki%s( .t2s sometimes use% to treat alcoholism! alcoholism! hea%aches! epilepsy!! %iabetes epilepsy %iabetes!! li$er %isease! ki%ney %isor%ers! %isor%ers! arthritis! arthritis! asthma! an o$eracti$e o$eracti$e thyroi%! thyroi%! 3untington2s %iseas sease! e! herpe erpes! s! #ourette2s syn%rome! -enier -eniere2s e2s %iseas %isease! e! an% other con%itions(
l%er a%ults; thyroi% %isease; epilepsy; concomitant use )ith haloperi%ol an% other antipsychotics; parkinsonism; %iabetes mellitus; se$ere in'ections; urinary retention(
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estlessness Loss o' appetite eight eight gain or )eight loss
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Stomach pain! gas! constipation! or in%igestion
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-il% thirst
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"ry mouth
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E&cessi$e sali$a in mouth
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Change in the ability to taste 'oo%
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S)ollen lips
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Acne
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3air loss
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E&treme %iscom'ort in col% temperatures
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"epression
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-uscle or oint pain
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.tching or rash
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#hin! brittle 'ingernails or hair
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-onito -onitorr respon response se to %rug( 6sual lag o' 178 )k prece%es prece%es response response to lith lithiu ium m thera therapy py(( ,eep physicia in'orme% o' progress( -onitor lithium le$el* 9ene 9enera rall lly y %osa %osag ge regimen is %esigne% to maintain seru lithium le$els o' 1(0 1(5 1(5 mE: mE:L L in acut acutee mani maniaa an% an% 0(<7 0(<71( 1(< < mE:L %uring maintenance trea treatm tmen ent; t; bloo loo% sample sample to %eterm %etermine ine serum lithium le$el is %ra) %ra)n n prio priorr to ne& ne& %ose =>718 h a'ter las %ose %ose?? )hen )hen lith lithiu iu le$el is 'airly stable( -oni -onito torr 'or 'or S@S S@S o lithium to&icity! o'te )hen )hen lithiu lithium m le$els le$els are are 1(57 1(578( 8(0 0 mE: mE:L L =e( g( g(! $omiting! %iarrhea! lack o coor%ination! %ro)siness! %ro)siness! muscula muscula )eak )eakne ness ss!! slur slurre re% % speech?( ithhol% one %ose an% cal physician( "rug shoul% not be stoppe% abruptly( hen hen lithiu lithium m le$els le$els are abo$e 8(0 mE:L! symptoms ma inclu%e ata&ia! blurre% $isi $ision on!! gi%% gi%%in ines ess! s! tinnitus! m us uscle
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3an% mo$ements that are %i''icult to control •
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t)itching or coarse tremors! an% a large output o' %ilute urine( eigh patient %aily check ankles! tibiae! an% )rists 'or e%ema( eport changes i .@ ratio! su%%e )eight gain! or e%ema( Poly%ipsia an% polyuria! apparentl not %ose/relate%! are common early a%$erse e''ects! particularly i ol%er a%ults( Symptoms may lesse but reappear a'te se$eral months or e$e years o' maintenance( eport early signs o e&trapyrami%al reactions promptly to physician( #he encephalopathic syn%rome may be in%uce% )hen lithiu is gi$en concomitantl )ith haloperi%ol o )ith othe antipsychotic me%ication! particularly in ol%e a%ults( ,eep physicia in'orme% o' al presenting S@S( #he 'ine tremor o' han% o a)! polyuria! mil% thirst! transient mil% nausea! an% genera %iscom'ort that ma occur in earl treatment o' mani sometimes persis
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throughout therapy( 6sually! ho)e$er! symptoms subsi%e )ith temporar re%uction o' %ose( . symptoms persist! %rug is )ith%ra)n( -onitor thyr oi% 'unction perio%ically( e alert to an% report symptoms o hypothyroi%ism( Neonates born o mothers )ho took lithium %uring pregnancy may ha$e high serum lithiu le$el mani'este% b 'lacci%ity! poo re'le&es! car%iac %ysrhythmia! an% chronic t)itching( Lithane contains tartraine! )hich ma cause an allergic/type reaction in susceptible patients( -onitor ol%er a%ults care'ully to pre$en to&icity! )hich ma occur at serum le$els or%inarily tolerate% b other patients(
