Psychiatric-Mental Health Nurse Practitioner Exam

Which psychiatric medication may have increased levels when used concurrently with ACE inhibitors?

1. Prozac

2. Lithium

3. Sertraline

4. Venlafaxine

The correct answer is: Lithium

Lithium is a medication that has a well-known interaction with ACE inhibitors. When taken together, ACE inhibitors can cause an increase in lithium levels due to their effect on renal function and fluid balance. ACE inhibitors can decrease the glomerular filtration rate (GFR), which can lead to reduced clearance of lithium from the body. This interaction is particularly important to monitor because elevated lithium levels can lead to toxicity, presenting symptoms such as tremors, confusion, and potential renal damage. For the other medications listed: Prozac (fluoxetine), sertraline, and venlafaxine do not have the same significant interactions with ACE inhibitors. Their pharmacokinetics and clearance mechanisms differ, making them less problematic in this context. Therefore, the concurrent use of ACE inhibitors with lithium necessitates close monitoring for potential increases in lithium concentrations, establishing lithium as the correct answer in this scenario.