Question

1. Provide evidence showing why lithium is a good choice for the treatment of bipolar disorder.
2. Describe appropriate dosing.
3. Describe how lithium works at the synapse. Why must blood levels of lithium be monitored? When should Jeremy’s first lithium check be? Why? Discuss what happens if levels are too high or too low.
4. Describe the education you would provide Jeremy as he starts on lithium

Answer 1

Answer- Lithium is an Antimanic agents or also called mood stabilizer. Lithium is a treatment of choice for the manic phase of the bipolar disorders, more commonly understood as mania or manic depression.

The major use of an antimanic agent is for treatment of mania and recurrent manic episodes.

How lithium works- Antimanic agents produce many neurochemical changes in the area of brain. These changes may affect norepinephrine and serotonin in the part of CNS involved in emotion. It may decrease the activity of the nerve impulse, resulting in depression or increase in the nerve impulse, causing mania. Lithium also helps in maintaining the sodium concentration in the brain, regulating the mood swings as well as impulse along the nerve cells.

The level of lithium in the blood should be monitored because- to determine the therapeutic level of lithium when starting lithium medication .. Or to determine lithium toxicity.

The lithium level should be first check - After five days , first start to take the lithium.

if lithium level is too high - it may lead to nausea , vomiting , diarrhoea ,fine hand tremors, malaise, dizziness, confusion , ataxia, slurred speech, acute circulatory failure , stupor coma , generalized convulsion, oliguria, or it can lead to death also

If lithium level is too low- frequent urination, thirst , constipation, hand tremors, dry mouth,

Education provide Jeremy as he starts on lithium is-

1) give advice that take medicine during or after meal to decrease gastric irritability.It will also reduce the metallic taste in the mouth.

2) advice the Jeremy fluid intake is to be balanced because retention of fluid will increase weight.

3) advice the Jeremy to take diet properly. Less intake of diet will affect the lithium level in the blood.

4) advice the jeremy that salt should not be restricted in the diet unless instructed by the physician

5) advice the Jeremy that if any problem occur like excessive weight gain, swelling of ankles and wrist ..immediately inform to the physician.