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Lithium is an element with atomic number 3 and atomic weight 7, which is the
smallest alkaline ion.
The element was discovered in 1817 by Arfuedson, since then, it has been
used for treatment of gout and for salt replacement in cardiac disease, but its
use was restricted due to fatal toxicity.
It was rediscovered in 1949 by John Cade, for use in treatment of mania but its
potential went unrecognized as it was discovered in Australia.
Mogen Schou in 1957, had to rediscover it yet again before it became popular
as a treatment of mania.
Pharmacokinetics:
Lithium is distributed rapidly in liver and kidney and more slowly in muscle,
brain and bone. Steady state levels are achieved in about 7 days.
Lithium alters sodium metabolism within nerve and muscle cells and enhance
(There are five known biogenic amines: dopamine, epinephrine,
norepinephrine, histamine and serotonin) the reuptake of biogenic amines in
the brain, lowering levels in the body and resulting in decreased hyperactivity.
Dosage
Lithium toxicity: toxicity occurs when serum lithium level >2.0 mEq/L
Pappular eruptions
Contraindications of lithium use
Severe dehydration.
Hypothyroidism.
History of seizures.
LITHIUM TOXICITY
However, they point out, “Patients unusually sensitive to Lithium may exhibit
toxic signs at serum levels below 1 mEq/L”.
The higher the serum level, the likelier there will be both side effects and the
appearance of toxic symptoms (also called lithium intoxication).
TYPES OF LITHIUM TOXICITY
This most commonly occurs when someone who it’s taking lithium at all
ingests it. This could occurs when a family member takes pills from the whole
bottle, when a child gets into a parent’s medications, or in a suicide attempt.
According to the researchers, acute toxicity can carry somewhat less medical
risk and less severe symptoms that the other types, depending on amount
taken.
Chronic Lithium Toxicity:
Impaired concentration
Muscle weakness
Convulsions
Muscle twitching
Dysarthria
Lethargy
Confusion
Coma
Pre-hospital care:
Gastric lavage may be attempted if the patient presents within one hour of
investigation.
Enhanced elimination:
It is also indicated in patient who cannot tolerate hydration such patients with
congestive heart failure (CHF) or liver disease.
Consult the poison control center and a medical toxicologist regarding appropriate
treatment.
REFERENCES
P.Subedi Durga, Mental health and psychiatric nursing, 4th edition, Makalu
publication 2018, page no. 370-375.
R Shreevani, A Guide to Mental Health & Psychiatric Nursing, 4th edition, Jaypee
Brothers Medical Publishers pvt. Ltd 2016, page no. 130 – 133.
Ahuja Neeraj, A Short textbook of Psychiatric, 7th edition, Jaypee Brothers Medical
Publishers pvt Ltd 2011, page no. 172-175
RETRIVED FROM:
https://www.webmd.com/bipolar-disorder/what-to-know-about-lithium-toxicity
https://www.healthline.com/health/lithium-toxicity