{"id":4149,"date":"2025-03-31T18:11:59","date_gmt":"2025-03-31T18:11:59","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/lithium-txt\/"},"modified":"2025-03-31T18:11:59","modified_gmt":"2025-03-31T18:11:59","slug":"lithium-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/lithium-txt\/","title":{"rendered":"Lithium.txt"},"content":{"rendered":"

Lithium <\/h1>\n

CLINICAL USE <\/H3>
\nTreatment and prophylaxis of mania, manic depressive illness, and recurrent depressionAggressive or self-mutilating behaviour

DOSE IN NORMAL RENAL FUNCTION <\/H3>See individual preparations. Adjust according to lithium plasma concentration

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :73.9<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :0<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 95<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.5\u20130.9<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :12\u201324\/40\u201350

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Avoid if possible, or reduce dose and monitor plasma concentration carefully
  • 10 to 20 &nbsp &nbsp : Avoid if possible, or reduce dose and monitor plasma concentration carefully
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Avoid if possible, or reduce dose and monitor plasma concentration carefully

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed in lithium intoxication. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed in lithium intoxication. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Dialysed in lithium intoxication. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsACE inhibitors and angiotensin-II antagonists: lithium excretion reduced\n
  • Analgesics: NSAIDs and ketorolac reduce excretion of lithium\n
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with amiodarone \u2013 avoid concomitant use\n
  • Antidepressants: increased risk of CNS effects with SSRIs; risk of toxicity with tricyclics; possible increased serotonergic effects with venlafaxine\n
  • Antipsychotics: increased risk of extrapyramidal side effects and possibly neurotoxicity with clozapine, haloperidol and phenothiazines; increased risk of ventricular arrhythmias with sertindole \u2013 avoid concomitant use; increased risk of extrapyramidal side effects with sulpiride\n
  • Diuretics: lithium excretion reduced by loop diuretics, potassium-sparing diuretics, aldosterone antagonists and thiazides; lithium excretion increased by acetazolamideMethyldopa: neurotoxicity may occur without increased lithium levels

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>Different preparations vary widely in bioavailability; a change in the preparation used requires the same precautions as initiation of treatment

    OTHER INFORMATION <\/H4>Doses are adjusted to achieve lithium plasma concentrations of 0.4\u20131.0 mmol\/L (lower end of range for maintenance therapy in elderly patients) in samples taken 12 hours after the preceding dose. It takes 4\u20137 days to reach steady stateLong-term treatment may result in permanent changes in kidney histology and impairment of renal function. High serum concentration of lithium, including episodes of acute lithium toxicity, may aggravate these changes. The minimum clinically effective dose of lithium should always be usedLithium carbonate.440 LiThiUM CArBonATEBennett (4th ed.) suggests 25\u201350% of normal dose if GFR <10 mL\/min, and 50\u201375% of normal dose if GFR between 10\u201350 mL\/min \u2013 monitor lithium plasma concentrations closelyLithium generally should not be used in patients with severe renal disease because of increased risk of toxicityDialysability: serum lithium concentrations rebound within 5\u20138 hours post haemodialysis because of redistribution of the drug, often necessitating repeated courses of haemodialysis. Peritoneal dialysis is less effective at removing lithium and is only used if haemodialysis is not possibleUp to one-third of patients on lithium may develop polyuria, usually due to lithium blocking the effect of ADH. This reaction is reversible on withdrawal of lithium therapy.
    \n","protected":false},"excerpt":{"rendered":"

    Lithium CLINICAL USE Treatment and prophylaxis of mania, manic depressive<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4149","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4149"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4149\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4149"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4149"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}