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Tuesday, December 16, 2014

Lithium Carbonate - Side Effects

What is lithium carbonate ?


Lithium carbonate (Li2CO3) is a lithium salt of Carbonic acid. It is a white powder, whose solubility in water decreases with increasing temperature. Lithium Carbonate is found in nature as the rare mineral zabuyeliet.

In the burning remains of plants (including tobacco) is lithium carbonate for.

Synthesis


Lithium carbonate can be prepared by a lithium aluminum silicate, such as spodumene, first heating with potassium sulfate (K2SO4), wherein among other things, creates lithium sulfate (Li2SO4). By reaction of this with lithium sulfate, sodium carbonate (Na2CO3) is created, inter alia, lithium carbonate.

Use as a medicament


Lithium carbonate is an old and very effective drug for treatment of bipolar disorder (formerly manic-depressive psychosis). It is also registered in order to be applied prophylactically. Lithium carbonate is, however, a means must be used with great care and precision.

History
In the nineteenth century was experimenting with lithium salts as a treatment for gout. Late 40s of the 20th century, lithium chloride was tried as a salt substitute in a sodium-restricted diet, with serious consequences, sometimes even resulting in death. In Australia discovered J.F.J. Cade that rats that were administered in an experiment, lithium carbonate, were drowsy. Cade tried it means when out with excitement and manic patients. In 1949 he wrote in an article that the agent is specifically worked with mania. He was initially believed.

Registered drug
Lithium carbonate is healthy subjects not happier and is hardly soothing. The drug has a specific effect on the symptoms of bipolar disorder: it goes against the symptoms of mania and stabilizes the mood between the phases, making them less frequent and less severe expired. The mechanism of action is not known; lithium ions affect many mechanisms in the nerve cell, including the sodium pump along the membranes, and working in the transmitters on dopamine and norepinephrine (not on serotonin) and on the further processing of the stimulus in the cell (so-called the second messenger). It is not known if any of these or another mechanism explains the mood stabilizing effect.

Indication
Lithium carbonate can be used in the manic phase, but an important use is also the prevention of both manic and depressive phases.

Dosage and precautions
The required dosage is determined blood level determination. In the manic phase is a mirror of about 1.0 mmol / L to pursue; if it is prescribed preventive pursued a mirror of 0.4 to 0.8 mmol / L. The mirror should be checked because this may change with a change in fluid balance, as in hot weather, fever and diarrhea with dehydration. Numerous drugs disrupt the blood: the most commonly used are diuretics, RAS inhibitors, NSAIDs and COX-2 inhibitors. According to the protocol will also renal and thyroid checked.

In 2006 and 2007 received a cardiologist and a pharmacist disciplinary warning concerning a deceased patient. The family doctor and psychiatrist were acquitted employed. The quartet paid insufficient mutual contact in the interactions between lithium carbonate and by the cardiologist added furosemide and fosinopril.

Lithium carbonate side effects
Lithium carbonate is recommended that the entire dose of the night to take once. Trembling hands, a salty taste in the mouth, thirst, excessive urination are common side effects. When the urination gets too bad, medical attention is needed to avoid that there arises renal diabetes insipidus. Lithium carbonate may be the cause of an underactive thyroid (hypothyroidism). Poisoning by lithium carbonate can lead to confusion, restlessness, tremors and even death.

Protocol
In practice, discussed the lithium clinic. Here, with lithium carbonate treated patients controlled according to a fixed schedule. Asked how the mood of the patient and will be asked if there are side effects have occurred. Renal function is the most important factors: high urine output (for example, more than 3.5 liters per 24 hours) deserves attention, but the salty taste in the mouth, because it may indicate a (potential) damage to the kidney (nephrogenic diabetes insipidus ). Control of weight and neck size are also important. In the blood, the amounts of lithium are, creatinine, TSH, and sodium determined.

Other Applications


Lithium carbonate is used in the production of aluminum, glass and ceramics, in order to improve the brightness and whiteness. Also, it is used as additive in cement, so that it dries faster.

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