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Lithium monitoring — GPhC CRA MCQ

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ModerateCNS TherapeuticsLithium monitoringGPhC CRA

A GP surgery asks what routine monitoring should be checked for a patient on long-term lithium who has been stable for 18 months. What monitoring is required?

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Correct answer: B — Lithium concentration, renal function, thyroid function and calcium at recommended intervals

Lithium requires therapeutic drug monitoring because the therapeutic index is narrow. Long-term monitoring includes lithium concentration, renal function, thyroid function and calcium, with frequency adjusted for stability and risk factors. Levels are usually interpreted as trough concentrations around 12 hours after dosing. The other tests are not the standard routine monitoring set for stable lithium therapy.

Reference: NICE CKS; BNF