QuestionSBA
QuestionChoice
Metformin is not known to interact with lithium to cause hypokalaemia
34297
c
Metformin hydrochloride 500 mg PO TDS
QuestionChoice
Indapamide is a thiazide-like diuretic that is used in the treatment of hypertension. It inhibits the Na+/Cl- cotransporter at the distal convoluted tubule of nephron, thereby leading to reduced sodium reabsorption and decreased water retention. It is important to note that it can cause hypokalaemia when given with lithium, thus potentially increasing the risk of torsade de pointes
34295
a
Indapamide 2.5 mg PO daily in the morning
QuestionChoice
Captopril can increase the concentration of lithium but is not known to interact with lithium to cause hypokalaemia. Angiotensin-converting-enzyme inhibitors like captopril are known to cause hyperkalaemia
34298
d
Captopril 75 mg PO BD
QuestionChoice
Amlodipine is not known to interact with lithium to cause hypokalaemia
34296
b
Amlodipine 10 mg PO OD
QuestionChoice
Simvastatin is not known to interact with lithium to cause hypokalaemia
34299
e
Simvastatin 40 mg PO ON
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2802
Lithium side effects
Topic
90
Psychiatry
6870
Case presentation: A 50-year-old woman visits her GP for medication review  


PMH: Bipolar disoder, Type 2 Diabetes Mellitus, Hypertension, Hypercholesterolaemia
DH: Her current regular prescriptions, in addition to lithium carbonate 600 mg PO twice daily, are listed in the options below
Investigations:


||||
|---------------------------|:-------:|--------------------|
|Sodium|138 mmol/L|135 - 145|
|Potassium|3.2 mmol/L|3.5 - 5.3|
|Urea|5 mmol/L|2.5 - 7.8|
|Creatinine|120 µmol/L|60 - 120|
|Thyroid Stimulating Hormone|2.5 mU/L|0.3 - 4.2|
|Total T4|120 nmol/L|60 - 150|


Question: Select the prescription that is most likely to interact with lithium carbonate to cause the abnormal blood test results?
a