Using the ADME mnemonic, discuss the pharmacokinetics of Lithium Carbonate, and how this applies to the management of this medicine in practice, including dosing and drug interactions.

Psychopharmacology & Medication Management in MH Nursing

Scenario

Jane is 25 years old. She is married and lives with her husband Ross. She works for a banking organisation as the assistant manager in her local branch. She likes to keep active, and tries to follow a healthy lifestyle and diet.

Jane has recently been diagnosed with bipolar I disorder. Five months ago, she experienced an acute manic episode, which required inpatient admission, and she was treated with risperidone and benzodiazepines to lower her mood. Following discharge, she experienced a period of depression, from which she has now recovered.

Following discussion with her MDT, Jane has now decided to start treatment with lithium as her single maintenance treatment, and has just been issued with the following prescription:

Lithium Carbonate Slow Release tablet 400mg at night.

Jane asks you for advice about her new medication; what would you tell her? You should consider compliance/concordance advice, required monitoring, and any signs and symptoms she should report to the team looking after her.

Discuss the pharmacodynamic effects of Lithium Carbonate, and how these could lead to the therapeutic effect, adverse drug reactions (side effects), and drug interactions.

Using the ADME mnemonic, discuss the pharmacokinetics of Lithium Carbonate, and how this applies to the management of this medicine in practice, including dosing and drug interactions.

(Approx 1000 words)

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