Introduction: Lithium has been used over time in the treatment of psychiatric pathologies, mainly the bipolar spectrum, however, the narrow therapeutic range generates a high incidence of poisoning by this metal, with a very heterogeneous clinical presentation of toxicity which will depend on two factors: the time of evolution, if it is acute or chronic, and the serum levels, ranging from gastrointestinal symptoms to severe neurological compromise. As of today, there is no specific antidote for lithium, so intermittent hemodialysis is the strategy of choice for the intoxicated patient. Objectives: To describe the available and relevant literature on the management of Lithium poisoning. Methodology: A search was performed with the MeSH terms "Lithium, Renal Dialysis, Poisoning, Toxicity, Acute kidney injury" in the ClinicalKey, PubMed and Ovid databases search engines, finding 156 results, of which 47 were used to develop this manuscript. Conclusions: Lithium poisoning is frequent due to its narrow therapeutic margin, so serum lithium levels should be monitored in patients medicated with it. Today there is no specific antidote, so renal replacement therapy is the best therapeutic option for lithium poisoning, demonstrating high efficiency, especially in cases of marked neurotoxicity. It is necessary to assess the need to initiate timely management in order to achieve a rapid clearance of the drug and decrease the rate of complications and mortality.
| Published in | American Journal of Internal Medicine (Volume 8, Issue 5) |
| DOI | 10.11648/j.ajim.20200805.14 |
| Page(s) | 215-220 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Lithium, Renal Dialysis, Poisoning, Toxicity, Acute Kidney Injury (MeSH)
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APA Style
Jorge Rico-Fontalvo, Rodrigo Daza-Arnedo, Victor Leal-Martínez, Emilio Abuabara-Franco, Nehomar Pájaro-Galvis, et al. (2020). Lithium Poisoning Update in Diagnosis and Treatment. American Journal of Internal Medicine, 8(5), 215-220. https://doi.org/10.11648/j.ajim.20200805.14
ACS Style
Jorge Rico-Fontalvo; Rodrigo Daza-Arnedo; Victor Leal-Martínez; Emilio Abuabara-Franco; Nehomar Pájaro-Galvis, et al. Lithium Poisoning Update in Diagnosis and Treatment. Am. J. Intern. Med. 2020, 8(5), 215-220. doi: 10.11648/j.ajim.20200805.14
AMA Style
Jorge Rico-Fontalvo, Rodrigo Daza-Arnedo, Victor Leal-Martínez, Emilio Abuabara-Franco, Nehomar Pájaro-Galvis, et al. Lithium Poisoning Update in Diagnosis and Treatment. Am J Intern Med. 2020;8(5):215-220. doi: 10.11648/j.ajim.20200805.14
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author = {Jorge Rico-Fontalvo and Rodrigo Daza-Arnedo and Victor Leal-Martínez and Emilio Abuabara-Franco and Nehomar Pájaro-Galvis and José Correa-Guerrero and Maria Raad-Sarabia and Alonso Pomares-Lara and Dayana Ayola-Rosales and Karen Mercado-Anillo and Yamile Sepúlveda-Hernandez and Huber Alvarado-Castell and Christian Pérez-Calvo},
title = {Lithium Poisoning Update in Diagnosis and Treatment},
journal = {American Journal of Internal Medicine},
volume = {8},
number = {5},
pages = {215-220},
doi = {10.11648/j.ajim.20200805.14},
url = {https://doi.org/10.11648/j.ajim.20200805.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20200805.14},
abstract = {Introduction: Lithium has been used over time in the treatment of psychiatric pathologies, mainly the bipolar spectrum, however, the narrow therapeutic range generates a high incidence of poisoning by this metal, with a very heterogeneous clinical presentation of toxicity which will depend on two factors: the time of evolution, if it is acute or chronic, and the serum levels, ranging from gastrointestinal symptoms to severe neurological compromise. As of today, there is no specific antidote for lithium, so intermittent hemodialysis is the strategy of choice for the intoxicated patient. Objectives: To describe the available and relevant literature on the management of Lithium poisoning. Methodology: A search was performed with the MeSH terms "Lithium, Renal Dialysis, Poisoning, Toxicity, Acute kidney injury" in the ClinicalKey, PubMed and Ovid databases search engines, finding 156 results, of which 47 were used to develop this manuscript. Conclusions: Lithium poisoning is frequent due to its narrow therapeutic margin, so serum lithium levels should be monitored in patients medicated with it. Today there is no specific antidote, so renal replacement therapy is the best therapeutic option for lithium poisoning, demonstrating high efficiency, especially in cases of marked neurotoxicity. It is necessary to assess the need to initiate timely management in order to achieve a rapid clearance of the drug and decrease the rate of complications and mortality.},
year = {2020}
}
TY - JOUR T1 - Lithium Poisoning Update in Diagnosis and Treatment AU - Jorge Rico-Fontalvo AU - Rodrigo Daza-Arnedo AU - Victor Leal-Martínez AU - Emilio Abuabara-Franco AU - Nehomar Pájaro-Galvis AU - José Correa-Guerrero AU - Maria Raad-Sarabia AU - Alonso Pomares-Lara AU - Dayana Ayola-Rosales AU - Karen Mercado-Anillo AU - Yamile Sepúlveda-Hernandez AU - Huber Alvarado-Castell AU - Christian Pérez-Calvo Y1 - 2020/08/20 PY - 2020 N1 - https://doi.org/10.11648/j.ajim.20200805.14 DO - 10.11648/j.ajim.20200805.14 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 215 EP - 220 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20200805.14 AB - Introduction: Lithium has been used over time in the treatment of psychiatric pathologies, mainly the bipolar spectrum, however, the narrow therapeutic range generates a high incidence of poisoning by this metal, with a very heterogeneous clinical presentation of toxicity which will depend on two factors: the time of evolution, if it is acute or chronic, and the serum levels, ranging from gastrointestinal symptoms to severe neurological compromise. As of today, there is no specific antidote for lithium, so intermittent hemodialysis is the strategy of choice for the intoxicated patient. Objectives: To describe the available and relevant literature on the management of Lithium poisoning. Methodology: A search was performed with the MeSH terms "Lithium, Renal Dialysis, Poisoning, Toxicity, Acute kidney injury" in the ClinicalKey, PubMed and Ovid databases search engines, finding 156 results, of which 47 were used to develop this manuscript. Conclusions: Lithium poisoning is frequent due to its narrow therapeutic margin, so serum lithium levels should be monitored in patients medicated with it. Today there is no specific antidote, so renal replacement therapy is the best therapeutic option for lithium poisoning, demonstrating high efficiency, especially in cases of marked neurotoxicity. It is necessary to assess the need to initiate timely management in order to achieve a rapid clearance of the drug and decrease the rate of complications and mortality. VL - 8 IS - 5 ER -
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