Lithium confusion from

We see from these examples that many of the carbon nucleophiles we encountered in Chapter 10 are also nucleophiles toward aldehydes and ketones (cf. Reactions 10-104-10-108 and 10-110). As we saw in Chapter 10, the initial products in many of these cases can be converted by relatively simple procedures (hydrolysis, reduction, decarboxylation, etc.) to various other products. In the reaction with terminal acetylenes, sodium acetylides are the most common reagents (when they are used, the reaction is often called the Nef reaction), but lithium, magnesium, and other metallic acetylides have also been used. A particularly convenient reagent is lithium acetylide-ethylenediamine complex, a stable, free-flowing powder that is commercially available. Alternatively, the substrate may be treated with the alkyne itself in the presence of a base, so that the acetylide is generated in situ. This procedure is called the Favorskii reaction, not to be confused with the Favorskii rearrangement (18-7). ... 

The lithium salt of A/-ethy)ethanamine (diethylamine) is called lithium diethylamide,4 but this nomenclature can lead to confusion With compounds of the type RC02NH2, which are derived from carboxylic acids and also are... 

A 58-year-old bipolar woman with previously stable therapeutic lithium concentrations was hospitalized with a 10-day history of confusion, disorientation, and agitation 8 weeks after starting to take candesartan 16 mg/day. Both drugs were withdrawn, the serum lithium concentration fell from a high of 3.25 mmol/1, and she was again maintained on her usual therapeutic concentration of lithium (578). 

The differences in bonding preferences in lithium acetylides may be confused by the competition from coordinating solvents. In the absence of solvent interactions, as in the crystal structure of Li-C=C-SiMe2-C6H4-OMe, nearly symmetric tt-interactions are observed. Computational... 

The effective treatment of a bipolar patient has necessitated doses of lithium that result in plasma levels of 1.4 to 1.5 meq/L. Lately he has begun to suffer from increased motor activity, aphasia, mental confusion, and social withdrawal. The best course of action would be to... 

A woman taking lithium carbonate developed signs of lithium toxicity (ataxia, dysarthria, tremor, confusion) within 2 to 3 weeks of starting to take enalapril 20 mg daily. After 5 weeks her plasma-lithium levels had risen from 0.88 to 3.3 mmol/L, and moderate renal impairment was noted. No toxicity occurred when the enalapril was later replaced by nifedipine. Lithium toxicity following the use of enalapril, and associated in some cases with a decrease in renal function, has been seen in another 5 patients, " and a reduced lithium dosage was found adequate in another patient. Enalapril 5 mg daily for 9 days had no effect on the mean serum-lithium levels of 9 healthy male subjects. However, one subject had a 31% increase in lithium levels. "... 

An elderly woman taking lithium carbonate developed lithium toxicity (ataxia, dysarthria, and confusion) after starting to take losartan 50 mg daily. Her serum-lithium levels rose from 0.63 to 2 mmol/L over 5 weeks. The lithium and losartan were stopped and her symptoms had disappeared 2 days later. When lithium therapy was restarted and the losartan was re-... 

A 56-year-old man taking lithium earbonate 400 mg three times daily for a bipolar disorder was admitted to hospital with bronchitis. He was started on levofloxacin 300 mg daily, and within 2 days was noted to have developed gait ataxia, dysarthria, coarse tremor, dizziness, vomiting, and confusion. Lithium toxicity was suspected, and because of the time course of the symptoms, an interaction with levofloxacin was considered responsible. Serum-lithium levels were found to have risen from 0.89 mmol/L (measured 2 weeks previously) to 2.53 mmol/L, and a reduction in his renal function was noted. Both drugs were stopped and the patient recovered over the following 4 days. His lithium level was found to be 1.12 mmol/L at that time. ... 

A man on long-term treatment with lithium earbonate became confused within a day of starting to take doxycycline 100 mg twice daily. By the end of a week he had developed symptoms of lithium toxicity (ataxia, dysarthria, worsened tremor, fatigue, etc.). His serum-lithium levels had risen from a range of 0.8 to 1.1 mmol/L up to 1.8 mmol/L his renal function remained normal. He recovered when the doxycycline was withdrawn. ... 

A 56-year-old woman, stabilised for over 9 years on lithium, with levels usually between 0.8 and I mmol/L, experienced lithium toxicity (unsteadiness, trembling, confusion) and was admitted to hospital on three occasions after taking piroxicam. Her serum levels on two occasions had risen to 2.7 and 1.6 mmol/L, although in the latter instance the lithium had been withdrawn the day before the levels were taken. In a subsequent study her serum-lithium levels rose from 1 to 1.5 mmol/L after she took piroxicam 20 mg daily. Two other case reports describe lithium toxiciN, which occurred 4 weeks and 4 months after piroxicam was started. ... 

Ion exchange membranes work in the temperature range of conventional fluid electrolytes, e.g., in electric cars from 0 °C to -1-80 °C and perhaps in the future up to -1-130 °C. This must not be confused with solid electrolytes, which are used in solid oxide fuel cells (SOFC) as oxygen ion conductors at up to 1,000 °C. Lithium ionconducting polymers are important components of high-power lithium ion secondary batteries, but that is not object of this entry. 

Note 2 The nomenclature assigned to pore dimensions is one which has been inherited over past decades. In the literature, the use of the term nanoporosity is appearing to distinguish it from other porosities. This is where some confusion now arises. The porosities of concern to adsorption processes are the micro- and mesoporosities, with dimensions of <2.0 nm and between 2.0 and 50 nm respectively that is, both have dimensions of nanometers. The terms micro and meso, as such, are essentially only a name and have no significance beyond that. In recent times, interest has centered on porosities in carbons with dimensions < 1.0 nm and which are responsible for the phenomena of activated diffusion (Chapter 4) and uptake of lithium as for the lithium-ion battery (the so-called nanoporosity). The literature also refers to ultra-mieroporosity, of suggested dimensions <0.7 nm as well as super-microporosity assigned to microporosity with dimensions nearer to the limit of 2.0 run, where three or four... 

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