Podcast 795: Lithium Toxicity

<p><strong>Contributor: Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Lithium remains a commonly used medication for treating bipolar disorder</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Lithium toxicity can be acute, acute-on-chronic, or chronic</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;"> </span><span style= "font-weight: 400;">Measuring blood lithium level</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Therapeutic range of lithium is around 1.6-1.8 mEq/L</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">>2 mEq/L is likely to cause significant toxicity</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">>4 mEq/L necessitates lifesaving treatment</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">The lethal dose of lithium is 700 mg/kg</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Lithium can have delayed absorption resulting in levels increasing during hospitalization</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Symptoms associated with acute lithium toxicity</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Gastrointestinal</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Na</span><span style="font-weight: 400;">usea, vomiting, abdominal pain</span></li> </ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Neurological</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Tremor, nystagmus, CNS depression (late finding)</span></li> </ul> <li style="font-weight: 400;" aria-level="2"><span style= "f