3) A 28 year old graduate student has a diagnosed history of bipolar disorder, characterized by his episodes of depression and mania. He has been experiencing recurrent manic episodes that significantly disrupt his daily functioning, impairing his relationships and work performance. Visiting his psychiatrist, he reports symptoms of restlessness, elevated mood, excessive talking, and a decreased need for sleep. As well, he discloses a previous history of depressive episodes. Based on his clinical presentation and medical history, his psychiatrist considers starting him on lithium treatment. a) Lithium has a very narrow therapeutic index, what are the implications of this that the student should be aware of? With so little room for error, what are some precautions the doctor should take to individualize the dosing to the patient's body? b) Lithium cations (Lit) have similar properties to sodium (Na), being directly above it in the periodic table, which enables it to enter cells through Nat channels. With over 90% of Lit being excreted into urine, only 20% is cleared as the rest is actively reabsorbed in competition with Nat at the same sites. What would happen if the student fashioned a low- sodium diet, or took other means sodium depletion? c) Lithium is administered as a salt, rather than the ion alone. Lithium carbonate, when ingested, dissociates accordingly: Li₂CO3 → 2Li+ + CO3²-. Many other drugs are administered as salts, such as amine-functionalized weak bases adding HCI (a strong acid) to their formulations, but why is this added? What is the equivalent for a weak acid drug - which functional group is typically present and which strong base is added?
3) A 28 year old graduate student has a diagnosed history of bipolar disorder, characterized by his episodes of depression and mania. He has been experiencing recurrent manic episodes that significantly disrupt his daily functioning, impairing his relationships and work performance. Visiting his psychiatrist, he reports symptoms of restlessness, elevated mood, excessive talking, and a decreased need for sleep. As well, he discloses a previous history of depressive episodes. Based on his clinical presentation and medical history, his psychiatrist considers starting him on lithium treatment. a) Lithium has a very narrow therapeutic index, what are the implications of this that the student should be aware of? With so little room for error, what are some precautions the doctor should take to individualize the dosing to the patient's body? b) Lithium cations (Lit) have similar properties to sodium (Na), being directly above it in the periodic table, which enables it to enter cells through Nat channels. With over 90% of Lit being excreted into urine, only 20% is cleared as the rest is actively reabsorbed in competition with Nat at the same sites. What would happen if the student fashioned a low- sodium diet, or took other means sodium depletion? c) Lithium is administered as a salt, rather than the ion alone. Lithium carbonate, when ingested, dissociates accordingly: Li₂CO3 → 2Li+ + CO3²-. Many other drugs are administered as salts, such as amine-functionalized weak bases adding HCI (a strong acid) to their formulations, but why is this added? What is the equivalent for a weak acid drug - which functional group is typically present and which strong base is added?
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Transcribed Image Text:3) A 28 year old graduate student has a diagnosed history of bipolar disorder, characterized
by his episodes of depression and mania. He has been experiencing recurrent manic
episodes that significantly disrupt his daily functioning, impairing his relationships and
work performance. Visiting his psychiatrist, he reports symptoms of restlessness, elevated
mood, excessive talking, and a decreased need for sleep. As well, he discloses a previous
history of depressive episodes. Based on his clinical presentation and medical history, his
psychiatrist considers starting him on lithium treatment.
a) Lithium has a very narrow therapeutic index, what are the implications of this that the
student should be aware of? With so little room for error, what are some precautions the
doctor should take to individualize the dosing to the patient's body?
b) Lithium cations (Lit) have similar properties to sodium (Na), being directly above it in the
periodic table, which enables it to enter cells through Nat channels. With over 90% of Lit
being excreted into urine, only 20% is cleared as the rest is actively reabsorbed in
competition with Nat at the same sites. What would happen if the student fashioned a low-
sodium diet, or took other means of sodium depletion?
c) Lithium is administered as a salt, rather than the ion alone. Lithium carbonate, when
ingested, dissociates accordingly: Li₂CO3 → 2Li+ + CO3²-. Many other drugs are administered
as salts, such as amine-functionalized weak bases adding HCI (a strong acid) to their
formulations, but why is this added? What is the equivalent for a weak acid drug - which
functional group is typically present and which strong base is added?
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