patients experiencing serious side effects which include diarrhea, oral ulcerations,
kidney damage with protein in the urine (proteinuria), and bone marrow suppression
(aplastic anemia).
8.8.1.4 Lithium
Lithium salts are used in the treatment of bipolar affective disorder (i.e., manic depres-
sion) and occasionally in mania (but its slow onset of action is somewhat of a disad-
vantage in this case). Its mechanism of action is still open to debate, but lithium has
effects on brain monoamines, on neuronal transmembrane sodium flux, and on cellular
phosphatidylinositides related to second messenger systems. Lithium is administered in
two salt forms, lithium carbonate (8.98) and lithium citrate (8.99). Side effects are
common and include diarrhea, kidney failure, and drowsiness with tremor.
8.8.1.5 Platinum
Platinum complexes (e.g.,cis-platinum,8.100) are used as antineoplastic agents in the
treatment of cancer. Their use is described in chapter 7.
8.8.1.6 Selenium
Selenium sulfide (8.101) is used dermatologically as an antiseborrheal agent. Selenium
acts as a cytostatic agent to decrease epidermal turnover rates in the skin.
534 MEDICINAL CHEMISTRY