NAPLEX / Psychiatric

All of the following are counseling points for patient on lithium except:

What are the early symptoms of chronic lithium toxicity?

Which of the following conditions can increase the risk of lithium toxicity?

LJ is a 77 year old female, who was brought by paramedics to ER from an assisted living facility with altered mental status, sluggishness, ataxia, confusion, agitation and severely low blood pressure. LJ is 5 feet 5 inches tall, wt. 75kg and NKDA. Her past medical history includes hypertension, GERD, asthma, osteoarthritis, depression, anxiety and bipolar disorder. Urinalysis is negative, chest x-ray show no evidence of active cardiopulmonary disease. Brain CT show no abnormality except for age related cortical atrophy. Pertinent labs includes sodium 138 mmol/L, potassium 4.5 mmol/L, carbon dioxide 30 mmol/L, creatinine 2.8 mg/dl, lithium level 4.3 mmol/L, lipase 668 units/L, albumin 3.1 g/dL, calcium 10 mg/dL, glucose 93mg/dL, BUN 36mg/dL. LJ’s home medications includes acetaminophen, lorazepam, albuterol inhalation, methocarbamol, furosemide, lamotrigine, lisinopril, lithium, gabapentin, primidone, lovastatin, pantoprazole, paroxetine. Which of the following medication can cause lithium toxicity?

LJ is a 77 year old female, who was brought by paramedics to ER from an assisted living facility with altered mental status, sluggishness, ataxia, confusion, agitation and severely low blood pressure. LJ is 5 feet 5 inches tall, wt. 75kg and NKDA. Her past medical history includes hypertension, GERD, asthma, osteoarthritis, depression, anxiety and bipolar disorder. Urinalysis is negative, chest x-ray show no evidence of active cardiopulmonary disease. Brain CT show no abnormality except for age related cortical atrophy. Pertinent labs includes sodium 138 mmol/L, potassium 4.5 mmol/L, carbon dioxide 30 mmol/L, creatinine 2.8 mg/dl, lithium level 4.3 mmol/L, lipase 668 units/L, albumin 3.1 g/dL, calcium 10 mg/dL, glucose 93mg/dL, BUN 36mg/dL. LJ’s home medications includes acetaminophen, lorazepam, albuterol inhalation, methocarbamol, furosemide, lamotrigine, lisinopril, lithium, gabapentin, primidone, lovastatin, pantoprazole, paroxetine. What should be monitored besides the lithium levels?

JP is a 40yr old male who was found lying on the floor with several empty liquor bottles by his friend. After being brought to the ER his serum alcohol level was found to be 475 mg/dl. Toxicology report negative except for high alcohol level. 2 hours after admission in the ER he was intubated and then transferred to ICU . His liver enzymes and renal function are normal. PT/INR within normal limit. No past medical history. Upon transfer medications includes Propofol, MVI daily, Lorazepam prn and Piperacillin/Tazobactam. What vitamin should the patient receive to avoid Wernicke- Korsakoff syndrome?

JP is a 40yr old male who was found lying on the floor with several empty liquor bottles by his friend. After being brought to the ER his serum alcohol level was found to be 475 mg/dl. Toxicology report negative except for high alcohol level. 2 hours after admission in the ER he was intubated and then transferred to ICU . His liver enzymes and renal function are normal. PT/INR within normal limit. No past medical history. Upon transfer medications includes Propofol, MVI daily, Lorazepam prn and Piperacillin/Tazobactam. What is the treatment of choice for his acute alcohol withdrawal?

JP is a 40yr old male who was found lying on the floor with several empty liquor bottles by his friend. After being brought to the ER his serum alcohol level was found to be 475 mg/dl. Toxicology report negative except for high alcohol level. 2 hours after admission in the ER he was intubated and then transferred to ICU . His liver enzymes and renal function are normal. PT/INR within normal limit. No past medical history. Upon transfer medications includes Propofol, MVI daily, Lorazepam prn and Piperacillin/Tazobactam. Which of the following would be appropriate chronic treatment of choice for his alcohol withdrawal?