McGraw Hill’s NAPLEX® Review Guide, 4e >Bipolar Disorders

S. Scott Sutton+
TABLE 58-2Lithium Monitoring

Baseline Laboratory/Ongoing Monitoring Explanation

SCr, BUN Renal excretion of lithium

Urine-specific gravity Polyuria caused by lithium

Lithium decreases the kidney's ability to concentrate the urine

Hyponatremia and dehydration can lead to ↑ renal reabsorption of lithium; ↑ lithium levels; lithium
Electrolytes
toxicity

Hypokalemia may ↑ the risk of lithium-induced cardiac toxicity

CBC with differential Lithium can ↑ WBC (except basophils)

Lithium can ↑ platelets

TSH; T4 Hyperthyroidism can mimic mania

Lithium can induce hypothyroidism with long-term treatment

ECG (in patients with cardiovascular disease risk; age >40) Lithium can worsen cardiac disease

Lithium can cause cardiac conduction abnormalities

Weight Lithium causes weight gain

Pregnancy test Lithium is pregnancy category D

Lithium can cause teratogenicity: Ebstein anomaly

Lithium levels Lithium is a narrow-therapeutic index drug; avoid toxicity

Levels assist in determining therapeutic response

Abbreviations: BUN, blood urea nitrogen; CBC, complete blood count; ECG, electrocardiography; SCr, serum creatinine; TSH, thyroid-stimulating hormone; WBC, white blood cell.

Date of download: 12/26/22 from AccessPharmacy: accesspharmacy.mhmedical.com, Copyright © McGraw Hill. All rights reserved.