Blood lithium

Lithium carbonate is rapidly absorbed after oral administration. The most common adverse reactions include tremors, nausea, vomiting, thirst, and polyuria Toxic reactions may be seen when serum lithium levels are greater than 1.5 mEq/L (Table 32-1). Because some of these toxic reactions are potentially serious, lithium blood levels are usually obtained during therapy, and the dosage of lithium is adjusted according to the results. 

Lithium was first used to treat manic-depressive illness in 1949, but was not used in the United States until 1970 due to concerns for its toxicity. When used as a therapeutic agent, lithium blood levels must be kept within a very narrow range (i.e., a narrow therapeutic index). Lithium appears to be non-essential, but it is readily absorbed by the intestine and is found in plants and meat. Normal daily intake is about 2 mg. Lithium is used in some manufacturing processes, as a lubricant, and as an alloy. 

Regular monitoring of lithium blood levels is necessary to determine proper dosage... 

Of the various mood-stabilizing agents being used in treating bulimic patients, only lithium was studied in a placebo-controlled, randomized trial, which was negative. Lithium is risky to use because of the dehydration experienced in bulim patients, which may result from purging behavior and thus rapidly increase lithium blood levels to a toxic level. 

Lithium is often used in the treatment of mania in the aged. Because it is cleared by the kidneys, dosages must be adjusted appropriately and blood levels monitored. Concurrent use of thiazide diuretics reduces the clearance of lithium and should be accompanied by further reduction in dosage and more frequent measurement of lithium blood levels. 

LITHIUM ANTIEPILEPTICS-CARBAMAZEPINE, PHENYTOIN t risk of neurotoxicity Uncertain this may occur with normal lithium blood levels Warn patients and carers to watch for drowsiness, ataxia and tremor... 

The polyuria which often accompanies lithium treatment is normally compensated for by drinking water, but when consciousness is impaired severe hypernatremia may develop. When any acute illness (particularly if associated with gastrointestinal symptoms) occurs or when new medication is given, lithium blood levels should be closely monitored, and the lithium dose adjusted. 

Mester R, Toren P, Mizrachi I et al. Caffeine withdrawal increases lithium blood levels. 

Lithium blood urine 14-crown-4 deriv. /CHCI3 50 >100 — 58,59... 

A paranoid schizophrenic taking chlorpromazine 200 to 600 mg daily for 5 years with no extrapyramidal symptoms developed stiffness of his face, arms and legs, and parkinsonian tremor of both hands within one day of starting to take lithium 900 mg daily. His lithium blood level after 3 days was 0.5 mmol/L. He was later given lithium 1.8 g daily (blood level... 

Mester R, Toren P, Mizrachi I, Wolmer L, KamiN, Weizman A. Caffeine withdrawal increases lithium blood levels. Biol Psychiatry (1995) 37,348-50. 

Mennen, L.I., G.R de Courcy, J.C. Guilland, et al. 2002. Homocysteine, cardiovascular disease risk factors, and habitual diet in the French Supplementation with Antioxidant Vitamins and Minerals Study. Am. J. Clin. Nutr. 76(6) 1279-1289. Mester, R., R Toren, and I. Mizrachi. 1995. Caffeine withdrawal increases lithium blood levels. Biol. Psychiatry 37(5) 348-350. Mills, S., and K. Bone. 2005. The essential guide to herbal safety. St. Louis Elsevier. 

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