S15C175 - Lithium Flashcards Preview

Tintinalli Section 15 - Toxicology > S15C175 - Lithium > Flashcards

Flashcards in S15C175 - Lithium Deck (5)
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1
Q

Lithium pharmackinetics

A
  • bear in mind that the levels in the brain and the serum can differ by 3-fold
  • elimination 1/2 life is 18-60h
  • excreted in urine
  • serum levels do not necessarily correlate with symptoms
2
Q

Lithium side-effect

A
  • tremor, polyuria, rash, fatigue, memory loss, ataxia, dysarthria, nephrogenic diabetes insipidus
  • worsening tremor is a sign of toxicity
  • n/v/d are common when starting tx
  • hypokalemia can occur causing u waves, flattened T, ST depression, QT prolongation
3
Q

Lithium OD signs

A
  • muscle fasciculations, ataxia, muscle weakness, agitation, lethargy, cognitive slowing
  • GI: n/v/d, gloating, abdo pain (seen more in acute toxicity)
  • renal impairment: polyuria, polydipsia
  • ECG: long QT, ST dpn, TWI
4
Q

Lithium levels

A
  • grade 1: 1.5-2.5 mEq/L n/v, tremor, hyperreflexia
  • grade 2: 2.5-4mEq/L stupor, rigidity, HoTN
  • grade 3: >4 mEq/L coma, Sz, requires HD (or 3.5mEq/L if chronic)
5
Q

Lithium OD tx

A
  • CBC, chem6, extended lytes, lithium level
  • Sz: benzos, barbs or general anesthesia
  • no charcoal, ineffective
  • 2L IV saline then 200cc/h
  • sodium polystyrene sulfonate
  • dialysis

-all acute ingestions get admitted, if chronic and minor can treat for 12h and d/c hom ief level