- Class
- Mood stabilizers
- Body system
- Mental health
- Brand names
- Lithobid
- Antidote or reversal
- There is no antidote; severe toxicity is treated with fluids and hemodialysis.
- Therapeutic level
- Commonly 0.6 to 1.2 mEq/L for maintenance (trough, about 12 hours after the dose).
What is Lithium used for?
- Bipolar disorder: acute mania and maintenance
How Lithium works
Mood stabilizer; the exact mechanism is not fully understood (it alters sodium transport and neurotransmitter signaling).
Common side effects
- Fine hand tremor
- Thirst and frequent urination
- Nausea and diarrhea at the start
- Weight gain
- Long term: hypothyroidism, kidney changes
Report right away
- Signs of toxicity: vomiting, diarrhea, coarse tremor, unsteady walk, muscle twitching, slurred speech, confusion
Nursing considerations for Lithium
- Narrow therapeutic range: maintenance levels are commonly 0.6 to 1.2 mEq/L. Draw levels as a trough, about 12 hours after the last dose.
- Dehydration, low sodium intake, vomiting, diarrhea, heavy sweating, thiazide diuretics, NSAIDs and ACE inhibitors raise lithium levels.
- Monitor kidney and thyroid function, and sodium.
Patient teaching
- Keep your salt intake and fluid intake steady (often about 2 to 3 liters a day unless told otherwise).
- Avoid dehydration in hot weather, exercise and illness; call your provider if you have vomiting or diarrhea.
- Do not take NSAIDs such as ibuprofen without asking.
- Keep every blood-level appointment.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Mood stabilizers practice questions
NCLEX-style questions on the class Lithium belongs to.
3 questions. Choose an answer to see the rationale.
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A patient on lithium has a level of 2.1 mEq/L with vomiting and coarse tremor. What is the priority?
Show answer
Answer A: Hold lithium and notify the provider: these are signs of toxicity A level above the therapeutic range with GI and neurologic symptoms indicates lithium toxicity.
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Which over-the-counter drug can raise lithium levels?
Show answer
Answer A: Ibuprofen NSAIDs reduce lithium excretion by the kidneys and can cause toxicity.
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What teaching about diet is correct for a patient on lithium?
Show answer
Answer B: Keep salt and fluid intake consistent Low sodium or dehydration makes the kidney keep more lithium; consistency keeps levels stable.
Frequently asked questions
What is Lithium used for?
Bipolar disorder: acute mania and maintenance.
What drug class is Lithium?
Lithium belongs to the class mood stabilizers. Mood stabilizer; the exact mechanism is not fully understood (it alters sodium transport and neurotransmitter signaling).
What are the nursing considerations for Lithium?
Narrow therapeutic range: maintenance levels are commonly 0.6 to 1.2 mEq/L. Draw levels as a trough, about 12 hours after the last dose. Dehydration, low sodium intake, vomiting, diarrhea, heavy sweating, thiazide diuretics, NSAIDs and ACE inhibitors raise lithium levels.
What should patients report while taking Lithium?
signs of toxicity: vomiting, diarrhea, coarse tremor, unsteady walk, muscle twitching, slurred speech, confusion.
What is the antidote for Lithium?
There is no antidote; severe toxicity is treated with fluids and hemodialysis.