(Georgette) PMHNP
Review Final exam 2025
2026 Exam Test Questions
And
Verified Answers
SCIENCE,MEDICINE,PSYC
HIATRY
,Lithium Level - normal
0.6-1.2
Lithium Toxicity
>1.5
Narrow therapeutic window
Lithium Gold Standard
Manic Episodes
has some slight effects on depressive symptoms
Long-standing history
Lithium has evidence for
Reducing suicidal ideation
Lithium for Bipolar
Is neuroprotective. The neuroprotective effects of lithium are attributed
to its ability to regulate several biological pathways and processes:
Neuroprotective
has properties that help protect neurons (nerve cells) from damage,
degeneration, or death. This effect is significant in the context of
neurodegenerative diseases, mood disorders, and other conditions that
involve neuronal injury.
Baseline Labs for Lithium
,Thyroid Panel (TSH)
Serum Creatinine (.06-1.2)
Blood Urea Nitrogen (BUN) 10-20
Pregnancy test (HCG) - all females 12-51 on psychotropics
EKG 50+
Side effects of Lithium
Endo (wt gain, hypothyroid)
CNS (fine hand tremor, fatigue, brain fog, HA, nystagmus)
Dermatological (maculopapular rash, acne, pruritis)
GI (Diarrhea, vomiting, cramps, anorexia)
Renal (Diabetes insipidus, polyuria/polydypsia, edema, tubular changes
in the kidneys)
Cardiac (T wave inversion, dysrhythmia)
Hematologic (leukocytosis - increased WBC)
Drugs that reduce renal clearance
Kidney disease, reduces renal clearance
NSAIDS (Ibuprophen, Indocin)
Thiazides (HCTZ)
Ace Inhibitors (Lisinopril)
these drugs cause an increase in serum concentration of the
drugs excreted by the kidney such as Lithium
Lithium excretion
Kidney - impacted by drugs that reduce renal clearance
Lithium toxicity
, Severe
Nausea, vomiting, diarrhea
Confusion, convulsions
drowsiness, blurred vision
slurred speech
Muscle weakness
Heart palpitations
Coarse hand tremors
Ataxia (unstable gait)
Treatment for Lithium Toxicity
First: DC Lithium, Check serum lithium levels
Management secondary: Vital signs, ekg,
Therapeutic effect of Lithium
Narrow therapeutic window
Draw at trough level, 12 hours post dose
Level at 1.2 and above is at risk for toxicity
Lithium and pregnancy
Category D
Lactation category L3
Elderly and psychotropics
More sensitive due to
decreased intracellular water
Protien binding
Review Final exam 2025
2026 Exam Test Questions
And
Verified Answers
SCIENCE,MEDICINE,PSYC
HIATRY
,Lithium Level - normal
0.6-1.2
Lithium Toxicity
>1.5
Narrow therapeutic window
Lithium Gold Standard
Manic Episodes
has some slight effects on depressive symptoms
Long-standing history
Lithium has evidence for
Reducing suicidal ideation
Lithium for Bipolar
Is neuroprotective. The neuroprotective effects of lithium are attributed
to its ability to regulate several biological pathways and processes:
Neuroprotective
has properties that help protect neurons (nerve cells) from damage,
degeneration, or death. This effect is significant in the context of
neurodegenerative diseases, mood disorders, and other conditions that
involve neuronal injury.
Baseline Labs for Lithium
,Thyroid Panel (TSH)
Serum Creatinine (.06-1.2)
Blood Urea Nitrogen (BUN) 10-20
Pregnancy test (HCG) - all females 12-51 on psychotropics
EKG 50+
Side effects of Lithium
Endo (wt gain, hypothyroid)
CNS (fine hand tremor, fatigue, brain fog, HA, nystagmus)
Dermatological (maculopapular rash, acne, pruritis)
GI (Diarrhea, vomiting, cramps, anorexia)
Renal (Diabetes insipidus, polyuria/polydypsia, edema, tubular changes
in the kidneys)
Cardiac (T wave inversion, dysrhythmia)
Hematologic (leukocytosis - increased WBC)
Drugs that reduce renal clearance
Kidney disease, reduces renal clearance
NSAIDS (Ibuprophen, Indocin)
Thiazides (HCTZ)
Ace Inhibitors (Lisinopril)
these drugs cause an increase in serum concentration of the
drugs excreted by the kidney such as Lithium
Lithium excretion
Kidney - impacted by drugs that reduce renal clearance
Lithium toxicity
, Severe
Nausea, vomiting, diarrhea
Confusion, convulsions
drowsiness, blurred vision
slurred speech
Muscle weakness
Heart palpitations
Coarse hand tremors
Ataxia (unstable gait)
Treatment for Lithium Toxicity
First: DC Lithium, Check serum lithium levels
Management secondary: Vital signs, ekg,
Therapeutic effect of Lithium
Narrow therapeutic window
Draw at trough level, 12 hours post dose
Level at 1.2 and above is at risk for toxicity
Lithium and pregnancy
Category D
Lactation category L3
Elderly and psychotropics
More sensitive due to
decreased intracellular water
Protien binding
