QuestionSBA
QuestionChoice
Taking lithium levels more than 12 hours after the initial dose may lead to inaccurate dose adjustments being made from a falsely low level
34398
d
Blood levels immediately before next dose
QuestionChoice
Lithium levels should be taken no earlier than 12 hours after a dose as this may lead to inaccurate dose adjustments being made from a falsely elevated level
34399
e
Blood levels immediately post-dose
QuestionChoice
Lithium levels should not be taken earlier than 12 hours after a dose as this may lead to inaccurate dose adjustments being made from a falsely elevated level
34396
b
Blood levels 2 hours post-dose
QuestionChoice
This is the correct time to take a lithium level, which is 12 hours after the last dose
34395
a
Blood levels 12 hours post-dose
QuestionChoice
Lithium levels should not be taken earlier than 12 hours after a dose as this may lead to inaccurate dose adjustments being made from a falsely elevated level
34397
c
Blood levels 6 hours post-dose
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
2822
Lithium side effects
Topic
90
Psychiatry
6890
Case Presentation: A 36 year old woman is seen in the outpatient psychiatry clinic and is diagnosed with bipolar disorder. She is advised to commence treatment with lithium carbonate (Camcolit) 400mg PO OD.


Question: Select the most appropriate monitoring option to assess the need for dose adjustments of lithium carbonate in this patient.
a