Multiple delayed peak lithium concentrations following acute intoxication with an extended-release product.
Ann Pharmacother
; 30(4): 356-60, 1996 Apr.
Article
en En
| MEDLINE
| ID: mdl-8729888
ABSTRACT
OBJECTIVE:
To describe delayed peak lithium concentrations after an overdose of extended-release lithium tablets. CASESUMMARY:
A patient with borderline personality disorder and depression ingested extended-release lithium approximately 20.25 g along with other agents. At presentation, the lithium concentration was 1.4 mEq/L. Significant enteral intake was initiated 27 hours after presentation and the lithium concentration 5 hours later increased to 3.2 mEq/L. A second lithium peak concentration of 5.0 mEq/L was noted 40 hours after presentation. Two hemodialysis sessions lasting 4 hours each were performed along with administration of sodium polystyrene sulfonate in sorbitol 20% to enhance lithium elimination and decrease absorption. Eighty-eight hours after presentation, the lithium concentration had decreased to 1.5 mEq/L.DISCUSSION:
Delayed and secondary peak lithium concentrations have been reported following an overdose with an extended-release product. Extended-release lithium may form an aggregate in the gastrointestinal tract and/or have delayed absorption secondary to coingested drugs. Toxicity may result if the patient begins enteral intake of drugs, fluids, or nutrition.CONCLUSIONS:
Continued monitoring of lithium concentrations after an acute ingestion with an extended-release product are recommended until lithium concentrations are less than 1.5 mEq/L and there are no signs of toxicity, particularly once the patient begins significant enteral intake.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Litio
/
Antidepresivos
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Ann Pharmacother
Asunto de la revista:
FARMACOLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos