á¹Ç·Ò§¡ÒôÙáÅÃÑ¡ÉÒ¾ÂÒºÒżÙé»èÇ·Õèä´éÃѺÂÒ Lithium

 

ÅÔà·ÕÂÁ (Lithium ) à»ç¹ÂÒ·Ò§¨ÔµàǪ·ÕèãªéÃÑ¡ÉÒÍÒ¡ÒäÅØéÁ¤ÅÑè§ â´ÂÁÕ¡Åä¡¡ÒÃÍÍ¡Ä·¸Ôì¤×Í ¡ÒÃáÂ觷Õè¡Ñºâ«à´ÕÂÁ㹡ÒüèÒ¹à¢éÒÍÍ¡ Sodium  channel ¢Í§Cell  ·ÓãËéÅ´¡ÒáÃеØé¹à«ÅÅì»ÃÐÊÒ·áÅСÒÃà¡çº¡ÅѺ¢Í§ÊÒÃÊ×è͵èÒ§ æ à¢éÒã¹à«ÅÅì  ÂҨж١´Ù´«ÖÁã¹·Ò§à´Ô¹ÍÒËÒà áÅж١¢ÑºÍÍ¡·Ò§äµ ÃдѺÂÒ·ÕèãËé¼Å㹡ÒÃÃÑ¡ÉÒÍÂÙè㹪èǧ 0.6 –1.2 mEq/ L

ºè§ªÕé¼Ùé»èÇÂãªé  Lithium

1.       Bipolar disorder

1.1   Acute manic episode

1.2   Acute depressive episode

1.3   Prophylaxis treatment

2.       ¡ÒÃãªéÅÔà·ÕÂÁ㹡óÕÍ×è¹æ

2.1   Schizo affective disorder

2.2   Treatment resistance schizophrenia

2.3   Cyclothymia

2.4   Aggression

2.5   Borderline Personality disorder (emotional unstable Personality disorder)

ÍÒ¡ÒâéÒ§à¤Õ§¢Í§ÂÒ Lithium

                Lithium ÁÕÍÒ¡ÒâéÒ§à¤Õ§·Õ辺ã¹ÍÇÑÂÇÐáÅÐÃкºµèÒ§ æ ´Ñ§¹Õé

1.      Ãкº·Ò§´Ô¹ÍÒËÒà ·ÓãËé¤Å×è¹äÊé  ÍÒà¨Õ¹  »Ò¡¤ÍáËé§ ËÃ×ͶèÒÂàËÅÇä´é»ÃÐÁÒ³ ÃéÍÂÅР    6 –20

2.      Ãкº»ÃÐÊÒ·Êèǹ¡ÅÒ§ ·Õ辺ÁÒ¡ÃéÍÂÅÐ 15 –53  ¤×ÍÍÒ¡Òà Fine Tremor ÍÒ¨¾ºÍÒ¡ÒÃÍè͹à¾ÅÕ ÇÔ§àÇÕ¹ÈÃÕÉÐ ÁÕ¡ÒÃà»ÅÕè¹á»Å§¡Ò÷ӧҹ¢Í§ÈÙ¹Âì¤Çº¤ØÁ¤ÇÒÁËÔÇáÅФÇÒÁÍÔèÁã¹ÊÁͧ·ÓãËé¼Ùé»èÇÂÃѺ»Ãзҹ¨Ø áÅйéÓ˹ѡà¾ÔèÁÁÒ¡

3.      ÃкºËÑÇ㨠 ÁÕ¡ÒÃà»ÅÕè¹á»Å§¢Í§¤Å×è¹ËÑÇ㨠 ÃÐÇѧ㹼Ùé»èÇ·ÕèÁÕâäËÑÇã¨

4.      Ãкºäµ  äµäÁèÊÒÁÒö Concentrate  »ÑÊÊÒÇÐä´é·ÓãËé »ÑÊÊÒÇкèÍ  áÅÐËÔǹéÓºèÍ ¾ºä´éÃéÍÂÅÐ 40

5.      µèÍÁä·ÃÍÂ´ì  ¾º Hypothyroidism »ÃÐÁÒ³ ÃéÍÂÅÐ 5 – 8

6.      ¼ÔÇ˹ѧ  à¡Ô´¼×è¹á¾é ÊÔÇáÅÐ Follicular eruption ä´é

ÀÒÇÐà»ç¹¾ÔɢͧÂÒ Lithium

                                áºè§à»ç¹ 3 ÃдѺ ¤×Í

ÃдѺ·Õè 1   Mild   (ÃдѺàÅ硹éÍ )  Blood Lithium = 1.5 – 2.0 mEq/ L

 

                                           ¼Ùé»èÇÂÁÕÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§¤×Í

                                                        ÊÁÒ¸ÔäÁè´Õ   Ë§Ø´Ë§Ô´    ¡ÅéÒÁà¹×éÍÍè͹áç  ÊÑè¹ ¾Ù´äÁèªÑ´ ¤Å×è¹äÊé

ÃдѺ·Õè 2    Moderated   (ÃдѺ»Ò¹¡ÅÒ§ ) Blood Lithium = 2.0 – 2.5 mEq/ L

                                            ¼Ùé»èÇÂÁÕÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§¤×Í

                                                       §Ø¹§§   ÊѺʹ  §èǧ«ÖÁ  ¾Ñ¡äÁèä´é  ·Ã§µÑÇäÁèÍÂÙè  ¾Ù´äÁèà»ç¹¤ÇÒÁ  ¡ÅéÒÁà¹×éÍ¡Ãеء  ÍÒà¨Õ¹

                                          µÒÁÑÇ   ªÑ¡

ÃдѺ·Õè 3  Severe  (ÃдѺÃعáç ) Blood lithium > 2.5 mEq/ L

                                         ¼Ùé»èÇÂÁÕÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§¤×Í

                                         à´Ô¹à« ¡ÅéÒÁà¹×éÍ¡Ãеء·Ñ駵ÑÇ  ªÑ¡  äÁèÃÙéÊÖ¡µÑÇ  äµÇÒ  â¤ÁèÒ

                   

á¹Ç·Ò§¡ÒôÙáÅÃÑ¡ÉÒ¼Ùé»èÇ·Õèä´éÃѺÂÒ Lithium  ÊÓËÃѺ¼Ùé»èÇ·ÕèÃѺäÇéÃÑ¡ÉÒã¹âç¾ÂÒºÒÅ

      1.á¹Ç·Ò§¡ÒôÙáÅ¡è͹¼Ùé»èÇÂä´éÃѺÂÒ Lithium

-          «Ñ¡»ÃÐÇѵÔâä»ÃШӵÑÇ àªè¹ âä䵠 ËÑÇ㨠áÅÐ âää·ÃÍ´ì 

-          ¡Ã³Õ¼Ùé»èÇ·ÕèÁÕâäËÑÇ㨠 ¤ÇõÃǨ´Ù¼Å¡ÒÃ·Ó EKG ´éÇ ( ¶éÒÁÕ )

-          ´ÙáÅãËéä´éÃѺ¡ÒõÃǨ·Ò§Ëéͧ»¯ÔºÑµÔ¡Òà  ´Ñ§µèÍ仹Õé  CBC  UA  BUN  Cr. áÅÐ

       Urine Preg – test  ã¹Ë­Ô§ÇÑÂà¨ÃÔ­¾Ñ¹¸Øì

     2. á¹Ç·Ò§¡ÒôÙáÅ¢³Ð¼Ùé»èÇÂä´éÃѺÂÒ Lithium  ( ¢³ÐÍÂÙèÃÑ¡ÉÒã¹âç¾ÂÒºÒÅ )

2.1   »ÃÐàÁÔ¹ãËé¡ÒôÙáÅà¾×èͪèÇÂàËÅ×ÍãËé¼Ùé»èÇ»ÅÍ´ÀѨҡÍÒ¡ÒâéÒ§à¤Õ§¢Í§ÂÒâ´Â                      

            1. àÁ×èͼÙé»èÇ»ҡáËé§ ¤ÍáËé§ á¹Ð¹ÓãËé¨Ôº¹éÓºèÍÂæ ËÃ×ÍãËéÍÁÅÙ¡ÍÁ

            2.àÁ×èͼÙé»èÇÂÁÕÍÒ¡ÒäÅ×è¹äÊé ¤ÇÃãËé¼Ùé»èÇÂÃѺ»ÃзҹÂÒÅ´¡Ã´ã¹¡ÃÐà¾Òзѹ·ÕËÅѧ

                ÍÒËÒÃËÃ×;ÃéÍÁÍÒËÒÃ

3. ¡Ã³Õ¼Ùé»èǧèǧ«ÖÁ »Ç´ÈÕÃÉÐ äÁèÁÕÍÒ¡ÒÃÍ×è¹æ ÃèÇÁ´éÇ ´ÙáÅãËé¾Ñ¡¼è͹ §´ÃèÇÁ¡Ô¨¡ÃÃÁ 

    ¡ÅØèÁ

            4. ãËé¤ÇÒÁÃÙéÇÔ¸Õ¡ÒôÙáŵ¹àͧ¢³Ðä´éÃѺ¡ÒÃÃÑ¡ÉÒ´éÇÂÂÒ Lithium ẺÃÒºؤ¤ÅáÅР 

                ÃÒ¡ÅØèÁ

            5.ºÑ¹·Ö¡ÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§ à½éÒÃÐÇѧ㹡ÅØèÁ¼Ùé»èÇ Hight alert daug áÅÐÊ觵èÍ·ÕÁ   

                ÊËÇÔªÒªÕ¾

2.2   ´ÙáÅà¾×èÍà½éÒÃÐÇѧ»éͧ¡Ñ¹¡ÒÃà¡Ô´ÀÒÇСÒÃà»ç¹¾ÔɢͧÂÒâ´Â

1.  ´ÙáÅãËé¼Ùé»èÇÂä´éÃѺ¡ÒõÃǨLithium level  ã¹¡ÃÐáÊàÅ×Í´  ·Ø¡ 1 ÊÑ»´ÒËì  µÅÍ´

     ÃÐÂÐàÇÅÒÍÂÙèÃÑ¡ÉÒã¹âç¾ÂÒºÒÅ â´ÂÁÔµéͧÁÕ¤ÓÊÑè§á¾·Âì

     ( à¨ÒÐàÅ×Í´ËÅѧÃѺ»ÃзҹÅÔà·ÕÂÁÁ×éÍÊØ´·éÒÂä»áÅéÇ 12 ªÑèÇâÁ§  )

2.   ÇÑ´ V/S ·Ø¡ 4-6 ªÑèÇâÁ§

3.   ´ÙáÅãËé´×èÁ¹éÓÍÂèÒ§¹éÍ 6-8 á¡éÇ / Çѹ

4.   ´ÙáÅãËéä´éÃѺ»ÃзҹÍÒËÒ÷ÕèÁÕÃÊà¤çÁàÅ硹éÍÂ

5.       ´ÙáÅãËéËÅÕ¡àÅÕ觡ÒÃÍÂÙèã¹·ÕèÁÕÊÀÒ¾Ãé͹¨Ñ´ ËÃ×ÍÍÍ¡¡ÓÅѧ¡ÒÂÁÒ¡æ

6.       ¡Ã³Õ·ÕèÁÕÍÒ¡ÒÈÃé͹ËÃ×ÍÍÂÙè¡Åҧᴴ ãËéÊÇÁàÊ×éÍᢹÂÒÇ ãËé´×èÁ¹éÓÁÒ¡æ

7.       àÁ×èͼÙé»èÇÂÁÕÍÒ¡Ò÷éͧàÊÕÂãËé´×èÁ ORS  ·Ñ¹·Õà¾×èÍÃÑ¡ÉÒÃдѺà¡Å×ÍáÃèã¹ÃèÒ§¡ÒÂ

áÅÐ ÊѧࡵÍÒ¡ÒþÔɢͧ Lithium ¾ÃéÍÁºÑ¹·Ö¡ÍÒ¡ÒÃà»ÅÕè¹á»Å§

 8.  ÊѧࡵÍÒ¡ÒþÔɢͧ Lithium ¾ÃéÍÁºÑ¹·Ö¡ÍÒ¡ÒÃà»ÅÕè¹á»Å§

 9.  ¡Ã³ÕÃдѺÂÒ Lithium ã¹àÅ×Í´ÁÕ¤èÒà·èҡѺ 2.00 mmol/LËÃ×ÍÁÒ¡¡ÇèÒ ãËéËÂØ´ÂÒ Lithium

     ·Ñ¹·Õ áÅÐÃÒ§ҹᾷÂìà¨éҢͧä¢é·ÃÒº

                  2.3 ÇҧἹ¨Ó˹èÒ â´ÂãËé¢éÍÁÙŤÓá¹Ð¹Ó¼Ùé»èÇÂáÅЭҵÔà¡ÕèÂǡѺµÑÇ´ÙáÅ¢³ÐÍÂÙèºéÒ¹áÅÐÃкØÍÒ¡ÒüԴ»¡µÔ·Õèµéͧ¾ºá¾·Âì    ·Ó¤ÇÒÁà¢éÒ㹡ÒÃãªé Lithium Card    

  

 á¹Ç·Ò§»¯ÔºÑµÔµÑǼÙé»èÇ·Õèä´éÃѺÂÒ Lithium   ¢³ÐÍÂÙèºéÒ¹  ( ÊÓËÃѺ¼Ùé»èÇÂ/ ­ÒµÔ )

              1. ãËéÃѺ»ÃзҹÂÒÅÔà·ÕÂÁ (Lithium) ¾ÃéÍÁÁ×éÍÍÒËÒÃàÁ×èÍÃÙéÊÖ¡¤Å×è¹äÊé  à¹×èͧ¨Ò¡ÂÒÁռŷÓãËéà¡Ô´

                    ¡ÒÃÃФÒÂà¤×ͧ àÂ×è꼯 ¡ÃÐà¾ÒÐÍÒËÒà ËÃ×Í´×èÁ¹éÓÍØè¹à¾×èÍÅ´ÍÒ¡ÒäÅ×è¹äÊé

  2. ÃѺ»ÃзҹÍÒËÒ÷ÕèÁÕÃÊà¤çÁàÅ硹éÍÂ

  3. ´×èÁ¹éÓÍÂèÒ§¹éÍÂÇѹÅÐ 6-8 á¡éÇ

  4. ¶éÒ·éͧàÊÕ ¾ÂÒÂÒÁ´×èÁ¹éÓà¡Å×ÍáÃè ·Ñ¹·Õ à¾×èÍÃÑ¡ÉÒÃдѺà¡Å×ÍáÃèã¹ÃèÒ§¡ÒÂ

  5. ËÅÕ¡àÅÕ觡ÒÃÍÂÙèã¹·ÕèÁÕÍÒ¡ÒÈÃé͹¨Ñ´ ËÃ×Í¡ÒÃÍÍ¡¡ÓÅѧ¡ÒÂÁÒ¡æ ¡Ã³Õ·ÕèËÅÕ¡àÅÕè§äÁèä´éãËé´×èÁ 

      ¹éÓÁÒ¡æ

  6. §´´×èÁ¡Òá¿ áÅÐà¤Ã×èͧ´×èÁ·ÕèÁÕáÍÅ¡ÍÎÍÅì·Ø¡ª¹Ô´

  7. ãËéÃѺ»ÃзҹÂÒµèÍà¹×èͧ ÊÁèÓàÊÁÍ µÒÁá¼¹¡ÒÃÃÑ¡ÉҢͧᾷÂì

  8. ÁÒµÃǨàÅ×Í´ à¾×èÍ´ÙÃдѺÂÒÅÔà·ÕÂÁã¹àÅ×Í´µÒÁá¾·Âì¹Ñ´·Ø¡¤ÃÑé§ à¹×èͧ¨Ò¡ÃдѺÂÒã¹àÅ×Í´ÁÕ¼Å

      µèÍ¡ÒÃÃÑ¡ÉÒáÅФÇÒÁ»ÅÍ´ÀÑ¢ͧ¼Ùé»èÇÂ

 9. ãËé¹Ó Lithium Card  ä»´éÇ·ء¤ÃÑ駷Õèµéͧä»ÃѺºÃÔ¡Òà ·ÕèʶҹºÃÔ¡ÒÃÊÒ¸ÒóÊØ¢ à¾×èÍá¨é§ãËé

      à¨éÒ˹éÒ·ÕèÃѺ·ÃÒº

10. àÁ×èÍÁջѭËÒËÃ×ÍʧÊÑÂãËéµÔ´µèÍʶҹ¾ÂÒºÒÅã¡ÅéºéÒ¹ ËÃ×ÍàºÍÃìâ·ÃÈѾ·ì 043-227422 µèÍ

      2125  µÅÍ´ 24 ªÑèÇâÁ§

               

ÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§·Õè¤ÇáÅѺÁÒ¾ºá¾·Âì

à´Ô¹â«à«  ÊѺʹ  ¾Ù´äÁèªÑ´  ¡ÅéÒÁà¹×éÍÍè͹áç  ÍÒà¨Õ¹    ·éͧàÊÕÂ

 

á¹Ç·Ò§¡ÒôÙáżÙé»èÇ·Õèä´éÃѺ¡ÒÃÃÑ¡ÉÒ´éÇÂÂÒ Lithium  ÊÓËÃѺ¼Ùé»èǹ͡

1. á¹Ç·Ò§¡ÒôÙáÅ¡è͹¼Ùé»èÇÂä´éÃѺÂÒ Lithium

-          «Ñ¡»ÃÐÇѵÔâä»ÃШӵÑÇ àªè¹ âä䵠 ËÑÇ㨠áÅÐ âää·ÃÍ´ì 

-          ¡Ã³Õ¼Ùé»èÇ·ÕèÁÕâäËÑÇ㨠 ¤ÇõÃǨ´Ù¼Å¡ÒÃ·Ó EKG ´éÇ ( ¶éÒÁÕ )

-          «Ñ¡»ÃÐÇѵԡÒÃãªéÂÒ Lithium ÍÒ¡ÒâéÒ§à¤Õ§·Õ辺 áÅСÒõͺʹͧµèÍÂÒ

-          ´ÙáÅãËéä´éÃѺ¡ÒõÃǨ·Ò§Ëéͧ»¯ÔºÑµÔ¡Òà  ´Ñ§µèÍ仹Õé  CBC  UA  BUN  Cr. áÅÐ

       Urine Preg – test  ã¹Ë­Ô§ÇÑÂà¨ÃÔ­¾Ñ¹¸Øì

2. á¹Ç·Ò§¡ÒôÙáÅ¢³Ð¼Ùé»èÇÂä´éÃѺÂÒ Lithium 

    2.1 ´ÙáÅà¾×èͪèÇÂàËÅ×ÍãËé¼Ùé»èÇ»ÅÍ´ÀѨҡÍÒ¡ÒâéÒ§à¤Õ§¢Í§ÂÒâ´Â                      

            1. àÁ×èͼÙé»èÇ»ҡáËé§ ¤ÍáËé§ á¹Ð¹ÓãËé¨Ôº¹éÓºèÍÂæ ËÃ×ÍãËéÍÁÅÙ¡ÍÁ

            2.  àÁ×èͼÙé»èÇÂÁÕÍÒ¡ÒäÅ×è¹äÊé ¤ÇÃãËé¼Ùé»èÇÂÃѺ»ÃзҹÂҷѹ·ÕËÅѧÍÒËÒÃ

                 ËÃ×;ÃéÍÁÍÒËÒÃ

3. ¡Ã³Õ¼Ùé»èǧèǧ«ÖÁ »Ç´ÈÕÃÉÐ äÁèÁÕÍÒ¡ÒÃÍ×è¹æ ÃèÇÁ´éÇ ´ÙáÅãËé¾Ñ¡¼è͹ §´ÃèÇÁ   

    ¡Ô¨¡ÃÃÁ¡ÅØèÁ

            4. ãËé¤ÇÒÁÃÙéÇÔ¸Õ¡ÒôÙáŵ¹àͧ¢³Ðä´éÃѺ¡ÒÃÃÑ¡ÉÒ´éÇÂÂÒ Lithium ẺÃÒºؤ¤ÅËÃ×Í  

                 ÃÒ¡ÅØèÁ

2.2   ´ÙáÅà¾×èÍà½éÒÃÐÇѧ»éͧ¡Ñ¹¡ÒÃà¡Ô´ÀÒÇСÒóìà»ç¹¾ÔɢͧÂÒâ´Â

1. ´ÙáÅãËéä´éÃѺ¡ÒõÃǨËÒÃдѺÂÒ Lithium ËÅѧÃѺ»ÃзҹÂÒ¤ÃÑé§ááÍÂèÒ§¹éÍ 7 Çѹ

    áÅдÙáÅãËéä´éÃѺ¡ÒõÃǨËÒÃдѺ Lithium for Treatment 㹡ÃÐáÊàÅ×Í´  ·Ø¡ 2  

    à´×͹ ¢Öé¹ÍÂÙè¡Ñº´ØžԹԨ¢Í§á¾·Âì( à¨ÒÐàÅ×Í´ËÅѧÃѺ»ÃзҹÅÔà·ÕÂÁÁ×éÍÊØ´·éÒÂä»áÅéÇ

    12 ªÑèÇâÁ§  )

2. ´ÙáÅãËé´×èÁ¹éÓÍÂèÒ§¹éÍ 6-8 á¡éÇ / Çѹ

3. ´ÙáÅÃѺ»ÃзҹÍÒËÒ÷ÕèÁÕÃÊà¤çÁàÅ硹éÍÂ

4. ´ÙáÅãËéËÅÕ¡àÅÕ觡ÒÃÍÂÙèã¹·ÕèÁÕÊÀÒ¾Ãé͹¨Ñ´ ËÃ×ÍÍÍ¡¡ÓÅѧ¡ÒÂÁÒ¡æ

    ¡Ã³Õ·ÕèÁÕÍÒ¡ÒÈÃé͹ËÃ×ÍÍÂÙè¡Åҧᴴ ãËéÊÇÁàÊ×éÍᢹÂÒÇ ãËé´×èÁ¹éÓÁÒ¡æ

5. àÁ×èͼÙé»èÇÂÁÕÍÒ¡Ò÷éͧàÊÕÂãËé´×èÁ ORS  ·Ñ¹·Õà¾×èÍÃÑ¡ÉÒÃдѺà¡Å×ÍáÃèã¹ÃèÒ§¡ÒÂ

6. ãËé¤ÇÒÁÃÙé¼Ùé»èÇÂáÅÐ­ÒµÔ ¨Ñ´ãËé¼Ùé»èÇÂ/­ÒµÔ ä´éÃѺ Lithium Card ºÍ¡ÇÔ¸Õ´ÙáÅ¢³ÐÍÂÙèºéÒ¹

     áÅÐÃкØÍÒ¡ÒüԴ»¡µÔ·Õèµéͧ¾ºá¾·Âì

  á¹Ç·Ò§»¯ÔºÑµÔµÑǼÙé»èÇ·Õèä´éÃѺÂÒ Lithium   ¢³ÐÍÂÙèºéÒ¹  ( ÊÓËÃѺ¼Ùé»èÇÂ/ ­ÒµÔ )

1.  ÃÙéÊÖ¡¤Å×è¹äÊéãËéÃѺ»ÃзҹÂÒÅÔà·ÕÂÁ ¾ÃéÍÁÁ×éÍÍÒËÒà ËÃ×ÍàÁ×èÍÁÕÍÒ¡ÒÃ㹡ÃÐà¾ÒÐ à¹×èͧ¨Ò¡ÂÒÁÕ 

                   ¼Å·ÓãËéà¡Ô´¡ÒÃÃФÒÂà¤×ͧ àÂ×è꼯 ¡ÃÐà¾ÒÐÍÒËÒà ËÃ×Í´×èÁ¹éÓÍØè¹à¾×èÍÅ´ÍÒ¡ÒäÅ×è¹äÊé

2.   ÃѺ»ÃзҹÍÒËÒ÷ÕèÁÕÃÊà¤çÁàÅ硹éÍÂ

3.   ´×èÁ¹éÓÍÂèÒ§¹éÍÂÇѹÅÐ 6-8 á¡éÇ

4.       ¶éÒ·éͧàÊÕ ¾ÂÒÂÒÁ´×èÁ¹éÓà¡Å×ÍáÃè ·Ñ¹·Õ à¾×èÍÃÑ¡ÉÒÃдѺà¡Å×ÍáÃèã¹ÃèÒ§¡ÒÂ

5.       ËÅÕ¡àÅÕ觡ÒÃÍÂÙèã¹·ÕèÁÕÍÒ¡ÒÈÃé͹¨Ñ´ ËÃ×Í¡ÒÃÍÍ¡¡ÓÅѧ¡ÒÂÁÒ¡æ ¡Ã³Õ·ÕèËÅÕ¡àÅÕè§äÁèä´éãËé´×èÁ¹éÓÁÒ¡æ

6.       §´´×èÁ¡Òá¿ áÅÐà¤Ã×èͧ´×èÁ·ÕèÁÕáÍÅ¡ÍÎÍÅì·Ø¡ª¹Ô´

7.       ãËéÃѺ»ÃзҹÂÒµèÍà¹×èͧ ÊÁèÓàÊÁÍ µÒÁá¼¹¡ÒÃÃÑ¡ÉҢͧᾷÂì

8.       ÁÒµÃǨàÅ×Í´ à¾×èÍ´ÙÃдѺÂÒÅÔà·ÕÂÁã¹àÅ×Í´µÒÁá¾·Âì¹Ñ´·Ø¡¤ÃÑé§ à¹×èͧ¨Ò¡ÃдѺÂÒã¹àÅ×Í´ÁռŵèÍ¡ÒÃÃÑ¡ÉÒáÅФÇÒÁ»ÅÍ´ÀÑ¢ͧ¼Ùé»èÇÂ

9.       ¶éÒµéͧÃѺ»ÃзҹÍÒá¡é»Ç´ËÃ×ÍÂÒÅ´¤ÇÒÁ´Ñ¹âÅËÔµ¤ÇûÃÖ¡ÉÒá¾·Âì¡è͹ÃѺ»Ãзҹ

10.   ãËé¹Ó Lithium Card  ä»´éÇ·ء¤ÃÑ駷Õèµéͧä»ÃѺºÃÔ¡Òà ·ÕèʶҹºÃÔ¡ÒÃÊÒ¸ÒóÊØ¢ à¾×èÍá¨é§ãËéà¨éÒ˹éÒ·ÕèÃѺ·ÃÒº

11.   àÁ×èÍÁջѭËÒËÃ×ÍʧÊÑÂãËéµÔ´µèÍʶҹ¾ÂÒºÒÅã¡ÅéºéÒ¹ ËÃ×ÍàºÍÃìâ·ÃÈѾ·ì 043-227422 µèÍ 2125  µÅÍ´ 24 ªÑèÇâÁ§

ÍÒ¡ÒÃáÅÐÍÒ¡ÒÃáÊ´§·Õè¤ÇáÅѺÁÒ¾ºá¾·Âì

à´Ô¹â«à«  ÊѺʹ  ¾Ù´äÁèªÑ´  ¡ÅéÒÁà¹×éÍÍè͹áç  ÍÒà¨Õ¹    ·éͧàÊÕÂ

 

Clinical Pathway of  Lithium ( ÊÓËÃѺ¼Ùé»èÇ·ÕèÃѺäÇéÃÑ¡ÉÒ )

 

Date

Admission

ÊÑ»´ÒËì·Õè 1-2

ÊÑ»´ÒËì·Õè 3

 

Assessment   Assessment

 

-     »ÃÐàÁÔ¹ÊÀÒ¾¢³ÐÃѺãËÁè

-          Nursing Care Plan

-          D/C Plan Assessment

-          ãËé¡ÒþÂÒºÒÅ·ÕÊͤÅéͧ¡Ñº»Ñ­ËÒ/¤ÇÒÁµéͧ¡ÒÃ

 

-          »ÃÐàÁÔ¹ÊÀÒ¾¼Ùé»èÇÂËÅѧä´éÃѺ¡ÒþÂÒºÒÅ

-          »ÃÐàÁÔ¹¤ÇÒÁ¾ÃéÍÁ¡è͹ D/C

-          »ÃÐàÁÔ¹¡ÒÃãªéÂÒ â´ÂàÀÊѪ ¡è͹ D/C

Lab / Clinical

- CBC   BUN Cr.  UA   Preg-Test

- T3-4   LFT  EKG ´ØžԹԨ¢Í§á¾·Âì

-Bl. for Lithium ·Ø¡ 1 wk  

- ¹Ñ´ F/U

Treatment

Medication

-          Rx………….

-          §´ÂÒ………

- »ÃѺÂÒ / ÂÒµèÍà¹×èͧ

- àµÃÕÂÁÂÒà´ÔÁ

Consultation

 

-          ·º·Ç¹¼ÙéàªÕèÂǪҭ

-          àÀÊѪ¡Ã

-          âÀª¹Ò¡Ã

 

- àÀÊѪ¡Ãá¹Ð¹ÓàÃ×èͧÂÒ

Nutrition

 

-          ÍÒËÒÃÃÊà¤çÁàÅ硹éÍÂ

 

          - ÍÒËÒÃÃÊà¤çÁàÅ硹éÍÂ

ÍÒËÒÃÃÊ          - ÍÒËÒÃÃÊà¤çÁàÅ硹éÍÂ

Activity

 

-          ÃÐÇѧÍغѵÔàËµØ Ë¡ÅéÁ / v/s ·Ø¡ 4-6

-          ËÅÕ¡àÅÕ觡ÒÃÍÍ¡¡ÓÅѧ¡Ò·Õè·ÓãËéà˧×èÍÍÍ¡ÁÒ¡ /ÍÂÙè¡Åҧᴴ

-          ´×èÁ¹éÓºèÍ æ àÁ×èͻҡáËé§ ¤ÍáËé§

- ÃÐÇѧÍغѵÔàËµØ Ë¡ÅéÁ

- ËÅÕ¡àÅÕ觡ÒÃÍÍ¡¡ÓÅѧ¡Ò·Õè·ÓãËéà˧×èÍÍÍ¡ÁÒ¡

- v/s ·Ø¡ 4-6 / ¶Õè¢Öé¹µÒÁÍÒ¡ÒÃ

- á¹Ð¹Ó¡Ô¨¡ÃÃÁ /ÍÍ¡¡ÓÅѧ¡ÒÂàËÁÒÐÊÁµÒÁÊÀÒ¾¼Ùé»èÇÂ

Information

Teaching

Psycho Social

ãËé¢éÍÁÙÅÃѺãËÁè

-          ÇÔ¸Õ»¯ÔºÑµÔµÑÇ¢³ÐÍÂÙèÃÑ¡ÉÒ

-          ¡ÒÃÃÑ¡ÉÒ

-          ¡ÒõÃǨ Lab ¡è͹ÃÑ¡ÉÒ´éÇÂÂÒ

-          Çѹ¹Ñ´­ÒµÔ

-          à»Ô´âÍ¡ÒÊãËé«Ñ¡¶ÒÁ

-          Ê觵èÍ

-    ¨Ñ´ãËéä´éà¢éÒ¡ÅØèÁ¡Ô¨¡ÃÃÁ

-          ÊѧࡵÍÒ¡ÒâéÒ§à¤Õ§¢Í§ÂÒ àªè¹Íè͹à¾ÅÕ ¤Å×è¹äÊé ÍÒà¨Õ¹ ã¨ÊÑè¹

-          á¹Ð¹ÓÃѺ»ÃзҹÂÒ¾ÃéÍÁÍÒËÒÃà¾×èÍÅ´¡ÒÃÃФÒÂà¤×ͧ¢Í§ÂÒ

- ´×èÁ¹éÓÇѹÅÐ 6-8 á¡éÇ

-          ·º·Ç¹¡Òû¯ÔºÑµÔµÑÇ¢³ÐÍÂÙèºéÒ¹

-          ¡ÒÃÃѺ»ÃзҹÂÒ /à½éÒÃÐÇѧÍÒ¡ÒâéÒ§à¤Õ§¢Í§ÂÒ

-          (Lithium Card )

-          ¡Òþºá¾·ÂìµÒÁ¹Ñ´

-          à»Ô´âÍ¡ÒÊãËé«Ñ¡¶ÒÁ

Discharge

Plan

-          ¡Ó˹´¼ÙéÃѺ¼Ô´ªÍº

-          á¨é§¡Ó˹´D/C

 

-          ¡ÅѺºéÒ¹ä´éÍÂèÒ§»ÅÍ´ÀÑÂ

-          ¾ºá¾·ÂìÍÂèÒ§µèÍà¹×èͧ

-          »ÃÖ¡ÉÒ Tel 043-227422

Out come

 

-          ¼Ùé»èÇÂÁÕ¤ÇÒÁÃÙé/à¢éÒ㨡ÒÃÃÑ¡ÉÒ

-          ÃèÇÁÁ×Í»¯ÔºÑµÔµÒÁá¼¹¡ÒÃÃÑ¡ÉÒ

 

-          äÁèÁÕÀÒÇÐá·Ã¡«é͹ / »ÅÍ´ÀÑÂ

-          à¢éÒã¨ÇÔ¸Õ¡Òû¯ÔºÑµÔµÑÇáÅл¯ÔºÑµÔµÑÇä´é¶Ù¡µéͧ

-          ¾Ö§¾Íã¨ã¹¡ÒÃÃÑ¡ÉÒ

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