TANELLE TRUSLER
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TANELLE TRUSLER

BLOG #13

30 Apr 2021, 00:16 Publicly Viewable
  1. Mechanism of action of lithium: Lithium influences the IP3 and DAG 2nd messenger systems by decreasing the various enzymes which are very important for conversion and re-circulation of membrane phosphoinositides.
  2. The therapeutic index of lithium is 0,5-1.5mM which is very small and therefore the dosing of lithium should be done very carefully, and blood levels must be monitored to prevent lithium toxicity.
  3. Lithium as monotherapy is used for prophylaxis of manic and hypomanic episodes and treatment of an acute manic episode. Lithium is used in combination with antidepressants for the treatment of resistant or recurrent unipolar depression and self-mutilating or aggressive behavior.
  4. The renal clearance may be decreased by thiazide diuretics, new NSAIDs, ACE inhibitors, and fluoxetine. Renal clearance of lithium is increased by theophylline and caffeine. Lithium is neurotoxic in combination with carbamazepine, calcium-blockers, losartan, methyldopa, metronidazole, and phenytoin.
  5. Tremors, sedation, ataxia, aphasia, muscle weakness, fatigue, polydipsia, polyuria, nocturia, nephrogenic diabetes insipidus, thyroid enlargement, leucocytosis, edema, weight gain, acne, alopecia, and sexual dysfunction.
  6.  Lithium has been associated with an increased incidence of congenital cardiovascular abnormalities, but the incidence is very low, keep the risk-benefit in mind. Lithium is excreted into the breastmilk in high concentrations and thus breastfeeding is not suggested.
  7.  Lithium as monotherapy is used for prophylaxis of manic and hypomanic episodes and treatment of an acute manic episode.
  8. The NSAID is causes decreased clearance of the lithium and therefore can cause an increase in the patient’s weight and other side effects of lithium. I would rather recommend Tylenol, acetaminophen, for pain. It does not have any drug interactions with lithium.