Read the summary and the most important questions on The Maudsley Prescribing Guidelines in Psychiatry | 9781119442585 | David M. Taylor; Thomas R. E. Barnes; Allan H. Young

• 1 Bipolair disorder

• People with bipolair have ....intracellular concentration of sodium and calciumwhat does lithium for them?

  Heb higher intracellular concentration of sodium ( Na) en calcium ( CA)
  lithium can reduce these ( dus minder ca gaat naar intracellular)

• 5 plasma levels Lithium

• Plasma level Lithium  for the treatment of acute treatment of mania if necessarily adjunctive therapy with which agent(s)?

  0,8 -1,0 mmol /L
  singel agent antipsychotic with an evidence base for treating mania.  

• Treatment of acute mania in patients already on long-term lithium

  If optimal then adding a dopamine antagonist , dopamine partial agonist of valproate

• The highest tolerable lithium plasma level

  0,6-0,8 mmol/L , with the option to reduce it to 0,40-0,60 mmol/L in case of good response
  increase to 0,8-1,00 mmol /L in case of insufficient response en good tolerance. 

• What is the aim of treatment Lithium

  Complete remission of both manic and depressive episodes

• 7 adverse effects long term lithium therapy

• 7.1 GI gastro intestinal

• Gastrointestinal effects of Lithiumtherapy

  -Anorexia
  -nausea
  -diarrhoea

• 7.2 fine tremor

• Fine tremor treatment 

  Propranolol

• 7.3 polyuria

• Polyuria may occur frequently when Lithium is geven ---

  With twice daily dosing

• 7.5 nephrogenic diabetes insipidus

• Symptomen of diabetes insidiousare effects reversible and effect irreversible* symptomen ? 

  Dorst and polyuria
  * reversible if short en medium term
  * long term treatment ( >15 years)

• 7.7 hypothyroidism

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• TFTs usually return to normal , when ?

  When lithium is discontinued