Prescribing Safety Assessment (PSA) Practice Exam

When should Lithium be stopped prior to surgery?

1. One week before

2. The day before

3. The day of surgery

4. It should not be stopped

The correct answer is: The day before

Lithium is a medication commonly used in managing mood disorders, particularly bipolar disorder. When considering surgery, it is important to manage the patient's medication regimen carefully to minimize the risk of complications. Stopping lithium too close to surgery can lead to rebound mood instability and increase the risk of manic or depressive episodes, which can compromise the patient's overall health and recovery. Stopping lithium the day before surgery allows for a careful continuation of the medication while also enabling the healthcare team to monitor the patient’s renal and neurological status, particularly since lithium can impact these systems. This timing helps maintain some therapeutic levels in the body while observing any potential side effects and ensuring that the patient is stable for the surgical procedure. Additionally, halting lithium too far in advance can negatively impact the patient’s mental health status during a period that is already stressful due to impending surgery. Therefore, managing the timing of lithium discontinuation is crucial for maintaining both the physical and psychological well-being of the patient leading up to, and following, the surgical intervention.