(LITHIUM!!) toxicity

Read: EMCrit note

• Therapeutic levels = 0.8-1.2 mEq/L; >1.5 mEq/L confirm toxicity, and levels of 2.5 mEq/L or more require emergency management
• can cause histological changes in kidneys; should review every 2-3 yrs
• interferes with ADH function at collecting tubule >>water loss >> polyuria
• compensatory increase in ADH can be seen

Side Effects of LITHIUM:

• Loose motion, leukocytosis
• Increased thirst, Insipidus Diabetes (polydypsia, polyuria)
• Tremor (coarse; fine tremor with therapeutic level), Teratogenicity
• Hypothyroidism
• Impaired vision, Interstitial nephritis
• NaUsea + Vomiting
• Muscle weakness/metallic taste
• Miscellaneous - acne, weight gain, T wave flattening or inversion on ECG

Signs for toxicity

• hyper-reflexia
• ataxia/dysarthria
• Confusion/fits