Lithium

CLASS

  • mood stabiliser

MECHANISM OF ACTION

  • element of the alkali metal group
  • exact mechanism of action in mania is unknown
    • ? alters Na+ transport in muscle and nerves cells
    • ? alters intraneuro1nal metabolism of catecholamines

PHARMACEUTICS

  • oral tablet
  • available in controlled released formulation

DOSE

  • 250-1200mg in divided doses
  • BD for controlled released

INDICATIONS

  • bipolar disorder

ADVERSE EFFECTS

  • toxicity (see document on lithium toxicity)
  • interactions: haloperidol -> encephalopathic syndrome, neuromuscular blockers -> prolonged effect, ACE, diuretics and NSAIDs -> predispose to toxicity
  • nephrogenic diabetes insipidus
  • dehydration from decreased Na+ reabsorption in renal tubules
  • pseudotumour cerebri (increased ICP and papilloedema)

PHARMACOKINETICS

  • Absorption – bioavailability = > 90%
  • Distribution – Vd 1L/kg
  • Metabolism – nil
  • Elimination – t1/2 = 12-24 hrs depending on whether chronic therapy, renal

CCC Pharmacology Series

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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