Lithium: Understanding Its Use in Treating Bipolar Disorder

Introduction

• Lithium: Medication used to treat bipolar disorder
• Narrow Therapeutic Range: Common for patients to experience side effects

Visual Mnemonic: Pixarize Comedy Club

• Lithium Battery: Symbolizes lithium

Key Points to Remember

Treatment and Mechanism

• Mood Stabilizer: Treats bipolar disorder, especially manic phases
• Dual Drama Mask: Represents bipolar disorder (happy/sad)

Therapeutic Range and Toxicity

• Therapeutic Range: 0.6 to 1.2 mEq/L
• Toxicity Threshold: Above 1.5 mEq/L
• Frequent Blood Draws: Necessary to monitor lithium levels

Risk Factors for Lithium Toxicity

• Fluid Loss/Dehydration: Caused by diuretics, severe diarrhea, vomiting
• Encourage Hydration: Important for patients on lithium
• Low Sodium (Hyponatremia): Fluid follows sodium, low levels increase lithium concentration
• Kidney Function: Decreased kidney function increases risk (falling jelly beans)

Other Medications Increasing Risk

• NSAIDs: Should not be taken with lithium; use acetaminophen instead
• Thiazide Diuretics: Like NSAIDs, avoid use with lithium

Identifying Lithium Toxicity

• Early Signs: GI distress (nausea, vomiting, diarrhea, lack of appetite)
• Intervention: Do not administer next dose; notify provider and expect stat serum lithium level test
• Late Signs: Neurological problems (confusion, ataxia, tremors, twitching, sedation, seizures, increased urination)

Teratogenic Effects

• Teratogenic: Should not be given during pregnancy due to risk of birth defects

Recap

• Uses: Mood stabilizer for bipolar disorder
• Key Numbers: Therapeutic range (0.6-1.2 mEq/L), Toxicity threshold (1.5 mEq/L)
• Risk Factors: Fluid loss, low sodium, decreased kidney function, NSAIDs, thiazide diuretics
• Toxicity Signs: Early (GI distress), Late (neurological)
• Teratogenic: Not safe during pregnancy

Tips for the NCLEX

• With this mnemonic, you'll be confident in answering questions about lithium toxicity and use.