This drug is universally preferred treatment for bipolar disorder especially manic phase. The mood of patients suffering from bipolar disorder can swing between depression and mania. The anti-manic effects of lithium result as it prevent abnormal brain activity.
Mood stabilizer, Anti-manic
Counseling for Indications:
The selection of drug according to the clinical condition of patients is the domain of physician however pharmacist can help physician by acting as therapy consultant. Pharmacist should verify the use of drug in respective indications of patient.
Lithium is used to treat:
- Schizoaffective disorder
- Bipolar disorder
Counseling for Dose:
- Lithium comes as tablet, capsule, extended release tablet, solution to take by mouth.
- The tablets, capsules and solutions are taken 3 to 4 times a day.
- Take at around the same times every day.
- Swallow the extended release tablet whole do not split or chew.
Counseling for Side Effects:
Side effects are associated with almost all drugs that could cause serious health damage. The pharmacist should communicate all the possible side effects to the patient. It should be advised by pharmacist to patients that discontinue the drug therapy if you experience any or all of the following adverse events and seek medical attention immediately.
The common side effects are:
- Gastrointestinal disturbance
- Alerted vision
- Decreased thyroid function
- Improper co-ordination
- Muscle weakness
Counseling for Drug Interactions:
The use of two or more than two drugs concomitantly may cause drug interaction leading to either therapeutic failure or toxicity. Patients should be properly instructed to avoid co-administration of such drugs to prevent serious consequences.
Lithium has drug interaction with:
- Thiazides diuretics
- Nutritional supplements
- Non steroidal anti-inflammatory drugs (NSAIDs)
- Angiotensin converting enzyme inhibitors (ACEIs)
Counseling for Contraindications:
- Counsel the patient that it is contraindicated during breast-feeding as it can appear in milk so it is better to avoid it.
- It is contraindicated in patient having allergy from lithium
- Counsel the patient if he is suffering from organic brain syndrome, thyroid, heart, kidney disease, diarrhea, excessive sweating or fever than this drug is contraindicated in such abnormalities.
- It is also contraindicated during pregnancy (first trimester of pregnancy). If given (second and third trimester) than special monitoring of lithium in serum is necessary.
Counseling for Food –Drug Interactions:
- Counsel the patient that it is important to follow a proper diet, including the right amount of fluid and salt during treatment.
- Drinks that contain caffeine, tea, coffee, chocolate or milk are not allowed.
Counseling for Storage:
A pharmacist should counsel the patient that:
- Keep medication in a tightly closed container.
- Store at room temperature, away from heat, light and moisture.
Table 1: Important information about Lithium side effects and their possible solution.
|Side effects||What you should do?|
|Eat simple meal and avoid intake of spicy foods like burger and fast foods.|
|Feeling shaky||Patient may feel co-ordination difficulties especially during the early phase of therapy so patients should avoid such tasks which require fine activities.|
|Urination||Use lithium with plenty of water|
|Weight gain||Consult with your Physician if it happens|
Common Brand Names:
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The team of medimoon.com would like to say special thanks to Maleha Munir for her contribution in this article. Maleha Munier is one of the brilliant student of department of Pharmacy, Hajvery university, Pakistan.
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