Science Medicine Psychiatry
PMHNP Review (Georgette)
Save
Students also studied
Flashcard sets Study guides
Georgette Review PMHNP. Georgette LMR Lippincott Illustrated
388 terms 553 terms 20 terms
osujichristy Preview Kittrella_Whitlock Preview Jervis_Muthami
Lithium Level - normal 0.6-1.2
>1.5
Lithium Toxicity
Narrow therapeutic window
Manic Episodes
Lithium Gold Standard has some slight effects on depressive symptoms
Long-standing history
Lithium has evidence for Reducing suicidal ideation
Is neuroprotective. The neuroprotective effects of lithium are
Lithium for Bipolar attributed to its ability to regulate several biological pathways
and processes:
has properties that help protect neurons (nerve cells) from
damage, degeneration, or death. This effect is significant in the
Neuroprotective
context of neurodegenerative diseases, mood disorders, and
other conditions that involve neuronal injury.
Thyroid Panel (TSH)
Serum Creatinine (.06-1.2)
Baseline Labs for Lithium Blood Urea Nitrogen (BUN) 10-20
Pregnancy test (HCG) - all females 12-51 on psychotropics
EKG 50+
Endo (wt gain, hypothyroid)
CNS (fine hand tremor, fatigue, brain fog, HA, nystagmus)
Dermatological (maculopapular rash, acne, pruritis)
GI (Diarrhea, vomiting, cramps, anorexia)
Side effects of Lithium
Renal (Diabetes insipidus, polyuria/polydypsia, edema, tubular
changes in the kidneys)
Cardiac (T wave inversion, dysrhythmia)
Hematologic (leukocytosis - increased WBC)
, Kidney disease, reduces renal clearance
NSAIDS (Ibuprophen, Indocin)
Drugs that reduce renal Thiazides (HCTZ)
clearance 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
Severe
Nausea, vomiting, diarrhea
Confusion, convulsions
drowsiness, blurred vision
slurred speech
Lithium toxicity Muscle weakness
Heart palpitations
Coarse hand tremors
Ataxia (unstable gait)
First: DC Lithium, Check serum lithium levels
Treatment for Lithium Toxicity
Management secondary: Vital signs, ekg,
Narrow therapeutic window
Therapeutic effect of Lithium Draw at trough level, 12 hours post dose
Level at 1.2 and above is at risk for toxicity
Category D
Lithium and pregnancy
Lactation category L3
More sensitive due to
decreased intracellular water
Protien binding
Elderly and psychotropics
Low muscle mass
decreased metabolism
increased body fat
Occurs when MAOI (isocarboxazid, phenelzine, selegiline, and
tranylcypromine) are taken with foods containing tyramine
Hypertensive Crisis
When MAO is inhibited (like in MAOI) tyramine exerts a strong
vasopressor effect, stimulating the release of catecholamines,
epi and nor eip, which increase BP and HR
Tyramine Precursor to Norepinephrine
Isocarboxazid
Phenelzine
MAOIs
Selegiline
Tranylcypromine
PMHNP Review (Georgette)
Save
Students also studied
Flashcard sets Study guides
Georgette Review PMHNP. Georgette LMR Lippincott Illustrated
388 terms 553 terms 20 terms
osujichristy Preview Kittrella_Whitlock Preview Jervis_Muthami
Lithium Level - normal 0.6-1.2
>1.5
Lithium Toxicity
Narrow therapeutic window
Manic Episodes
Lithium Gold Standard has some slight effects on depressive symptoms
Long-standing history
Lithium has evidence for Reducing suicidal ideation
Is neuroprotective. The neuroprotective effects of lithium are
Lithium for Bipolar attributed to its ability to regulate several biological pathways
and processes:
has properties that help protect neurons (nerve cells) from
damage, degeneration, or death. This effect is significant in the
Neuroprotective
context of neurodegenerative diseases, mood disorders, and
other conditions that involve neuronal injury.
Thyroid Panel (TSH)
Serum Creatinine (.06-1.2)
Baseline Labs for Lithium Blood Urea Nitrogen (BUN) 10-20
Pregnancy test (HCG) - all females 12-51 on psychotropics
EKG 50+
Endo (wt gain, hypothyroid)
CNS (fine hand tremor, fatigue, brain fog, HA, nystagmus)
Dermatological (maculopapular rash, acne, pruritis)
GI (Diarrhea, vomiting, cramps, anorexia)
Side effects of Lithium
Renal (Diabetes insipidus, polyuria/polydypsia, edema, tubular
changes in the kidneys)
Cardiac (T wave inversion, dysrhythmia)
Hematologic (leukocytosis - increased WBC)
, Kidney disease, reduces renal clearance
NSAIDS (Ibuprophen, Indocin)
Drugs that reduce renal Thiazides (HCTZ)
clearance 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
Severe
Nausea, vomiting, diarrhea
Confusion, convulsions
drowsiness, blurred vision
slurred speech
Lithium toxicity Muscle weakness
Heart palpitations
Coarse hand tremors
Ataxia (unstable gait)
First: DC Lithium, Check serum lithium levels
Treatment for Lithium Toxicity
Management secondary: Vital signs, ekg,
Narrow therapeutic window
Therapeutic effect of Lithium Draw at trough level, 12 hours post dose
Level at 1.2 and above is at risk for toxicity
Category D
Lithium and pregnancy
Lactation category L3
More sensitive due to
decreased intracellular water
Protien binding
Elderly and psychotropics
Low muscle mass
decreased metabolism
increased body fat
Occurs when MAOI (isocarboxazid, phenelzine, selegiline, and
tranylcypromine) are taken with foods containing tyramine
Hypertensive Crisis
When MAO is inhibited (like in MAOI) tyramine exerts a strong
vasopressor effect, stimulating the release of catecholamines,
epi and nor eip, which increase BP and HR
Tyramine Precursor to Norepinephrine
Isocarboxazid
Phenelzine
MAOIs
Selegiline
Tranylcypromine
