Lithium Toxicity
- Clinical diagnosis as toxicity can occur at therapeutic levels
Common
- Overdose
- Sodium or fluid loss
- Concurrent medical illness
Clinical Features
L eukocytosis
I nsipidous (Diabetes)
T remor
H ypothyroidism
I ncreased weight
V omiting, nausea
M isc (ECG change, acne)
Investigations
- Serum lithium levels, BUN, electrolytes
Management
- Discontinue lithium for several doses and begin again at a lower dose when lithium level has fallen to a non-toxic range
- Saline infusion
- Haemodialysis if lithium >2 mmol/L, coma, shock, severe dehydration, failure to respond to treatment after 24 h, or deterioration
Source
Toronto Notes 2012