NAME OF THE DRUG MECHANISM OF INDICATION CONTRAINDICATION SIDE EFFECTS NURSING

ACTION RESPONSIBILITIES
GENERIC NAME:  The lithium ion  Lithium is a Older adults; thyroid disease;  Restlessness  Monitor response to
Lithium Carbonate behaves in the body medication epilepsy; concomitant use  Loss of appetite drug. Usual lag of 1–2
much like the sodium commonly used to with haloperidol and other  Weight gain or weight wk precedes response
BRAND NAME: ion; but its exact treat and prevent antipsychotics; loss to lithium therapy.
Eskalith mechanism of action mania episodes in parkinsonism; diabetes  Stomach pain, gas, Keep physician
is unclear. Competes people with bipolar mellitus; severe infections; constipation, or informed of progress.
CLASSIFICATION with various disorder. Mania is urinary retention. indigestion  Monitor lithium level:
CNS agent; physiologically abnormal  Mild thirst Generally dosage
Psychotherapeutic important cations: excitement, which  Dry mouth regimen is designed to
agent; Antimanic Na+, K+, Ca++, Mg+ may lead to  Excessive saliva in maintain serum
+; therefore, it affects undesirable mouth lithium levels of 1.0–
DOSAGE: cell membranes, body behaviors. 1.5 mEq/L in acute
 Change in the ability
450 mg 1 tab water, and  The medicine is also mania and 0.6–1.6
to taste food
neurotransmitters. At used to treat mEq/L during
 Swollen lips
ROUTE: the synapse, it depression, maintenance
Oral, OD  Acne
accelerates schizophrenia, eating treatment; blood
catecholamine  Hair loss
disorders, impulse sample to determine
destruction, inhibits  Extreme discomfort in serum lithium level is
control disorders, cold temperatures
the release of and certain mental drawn prior to next
neurotransmitters and  Depression dose (8–12 h after last
illnesses in kids.
decreases sensitivity  Muscle or joint pain dose) when lithium
of postsynaptic
 It's sometimes used  Itching or rash level is fairly stable.
to treat alcoholism,  Thin, brittle
receptors.  Monitor for S&S of
headaches, fingernails or hair
epilepsy, diabetes, lithium toxicity, often
 Inhibits  Hand movements that when lithium levels
liver disease, kidney are difficult to control
neurotransmitters; are 1.5–2.0 mEq/L
disorders, arthritis,
decreases over-activity (e.g., vomiting,
asthma, an
of receptors involved diarrhea, lack of
overactive thyroid,
in stimulating manic coordination,
Huntington's
states. Response drowsiness, muscular
disease, herpes,
evidenced by changed weakness, slurred
Tourette's syndrome,
facial affect, improved speech). Withhold one
Meniere's disease,
posture, assumption of dose and call
and other conditions.
self-care, improved physician. Drug
ability to concentrate, should not be stopped
improved sleep abruptly.
pattern.  When lithium levels
are above 2.0 mEq/L,
symptoms may
include ataxia, blurred
vision, giddiness,
tinnitus, muscle
 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.