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Lithium carbonate is a medication used for the treatment of several mental disorders such as mania, bipolar affective disorder, recurrent depression, aggression, and self-mutilating behavior. Like sodium and potassium, lithium is a monovalent cation in the alkali metal group. Lithium is not metabolized, and most is excreted by the kidneys. Lithium has various psychiatric actions, such as inhibition of noradrenergic adenylate cyclase activity and the augmentation of presynaptic noradrenaline reuptake; however, the exact pharmacological effect

antipsychotic drugs are effective. Extensive clinical studies have found that the relapse rate is much greater for patients who discontinue antipsychotic medication, compared with those who continue therapy. It is significant that antipsychotic drugs are not disease specific; they can be used for conditions other than schizophrenia and other psychoses. These include acute agitation and delirium associated with Alzheimer dementia, fever, septicemia, amphetamine intoxication, or mechanical ventilation. They are frequently used in combination with lithium and

acute pain will be highlighted in this article. In addition to these agents, the anti-epileptic drugs (AEDs) are also very commonly used for neuropathic and neurovascular pains. 7 The muscle relaxants are not as useful in chronic as in acute musculoskeletal pain, 8 although the antispastics, a different group including baclofen and tizanidine, show utility in a number of disorders. The various primary headaches utilize a wide array of medications from many classes in addition to those above: beta blockers, calcium channel blockers, lithium, “triptans

of a continuous electrocardiogram (ECG) is generally advised in consultation with a cardiologist and electrophysiologist. Additionally, many pacemakers have the capability to be “interrogated” as to their function and frequency of events with proprietary software specific to the manufacturer of the device. Generally, the lithium-ion batteries in contemporary pacemakers have a working life of approximately 10 years. Function and sensing abilities may begin to degrade over a gradual period of time rather than there being an abrupt cessation of pacing

Finally, serum levels of lithium and methotrexate are elevated during concurrent consumption of NSAIDs. To prevent toxicity, NSAIDs should be avoided in patients medicated with these agents, particularly those taking high‐dose regimens. Acetaminophen is the preferred alternative when NSAIDs must be avoided. It shares none of the side effects or potential drug interactions. However, it is potentially hepatotoxic and this risk is increased with liver dysfunction or other drugs that may alter its biotransformation. Acetaminophen‐induced hepatotoxicity is

lithium and high-dose methotrexate by competing with the renal excretion of both. 24 DPSGC has not been well studied in pediatric, pregnant, or geriatric patients or patients who are in labor and delivery or nursing. NSAIDs close the ductus arteriosus by inhibiting prostaglandin synthesis. DPSGC is considered a Pregnancy Category C drug before 30 weeks gestational age, meaning that the drug should be used only if the therapeutic benefit outweighs any potential harm to the fetus. At 30 weeks, DPSGC is considered a Pregnancy Category D drug and should be avoided

are managed with medication, pacemakers are required in refractory cases. Cardiac pacemakers are implanted in more than a million people in the United States each year. They are used most often in patients suffering symptomatic supraventricular arrhythmias and heart blocks unresponsive to drug therapy. Pacemakers have 2 essential components: (1) a pulse generator powered by a lithium-iodine battery, and (2) pacing leads. These leads are stainless steel wires that most often are introduced via the subclavian or external jugular veins and guided to the cardiac chamber

for GI mucosal injury in patients taking selective serotonin reuptake inhibitor (SSRI) antidepressants and NSAIDs. This risk is most significant after prolonged use of NSAIDs, but caution may be advised during short-term use for patients who have a previous history of mucosal injury. 20 , 21 Finally, serum levels of lithium and methotrexate are elevated during concurrent consumption of NSAIDs. To prevent toxicity, NSAIDs should be avoided in patients medicated with these agents, particularly those taking high-dose regimens