PSYCHIATRY
LITHIUM TOXICITY
PromptACUTE
Response
PromptClinical features of large acute lithium overdose
Response<25g - MIld-moderate GI
>25g - mod-severe GI symptoms +/- neurotoxicigy (which is rare)
>25g - mod-severe GI symptoms +/- neurotoxicigy (which is rare)
PromptCHRONIC
Response
PromptFactors predisposing to chronic lithium toxicity
ResponseImpaired renal function
Diabetes insipidus
Sodium depletion
Dehydration
Drug interactions (NSAIDs, ACEi, Thiazides)
Diabetes insipidus
Sodium depletion
Dehydration
Drug interactions (NSAIDs, ACEi, Thiazides)
PromptClinical features of chronic lithium toxicity
ResponseMostly neurotoxicity/progressive based on symptoms
Grade 1 - Tremor, agitation, hyperreflexia, ataxia
Grade 2 - Stupor, rigidity, hypotension
Grade 3 - Coma, seizure, myoclonus
Grade 1 - Tremor, agitation, hyperreflexia, ataxia
Grade 2 - Stupor, rigidity, hypotension
Grade 3 - Coma, seizure, myoclonus
PromptHaemodialysis indications
ResponseEstablished neurotoxicity
Serum lithium >2.5
Renal impairment.
Serum lithium >2.5
Renal impairment.