Podcast 795: Lithium Toxicity

Podcast 795: Lithium Toxicity

Contributor: Peter Bakes, MD

Educational Pearls:

  • Lithium remains a commonly used medication for treating bipolar disorder
  • Lithium toxicity can be acute, acute-on-chronic, or chronic
  • Measuring blood lithium level
    • Therapeutic range of lithium is around 1.6-1.8 mEq/L
    • >2 mEq/L is likely to cause significant toxicity
    • >4 mEq/L necessitates lifesaving treatment
    • The lethal dose of lithium is 700 mg/kg
    • Lithium can have delayed absorption resulting in levels increasing during hospitalization
  • Symptoms associated with acute lithium toxicity
    • Gastrointestinal
      • Nausea, vomiting, abdominal pain
    • Neurological
      • Tremor, nystagmus, CNS depression (late finding)
    • Cardiovascular
      • Bradycardia, QT prolongation, EKG changes
  • Treatment for lithium toxicity
    • ABCs
    • Get a good history
    • GI Decontamination:
      • Whole bowel irrigation if patient ingested extended-release tablets
    • Dialysis
      • Most effective treatment for lithium toxicity

References

Baird-Gunning J, Lea-Henry T, Hoegberg LCG, Gosselin S, Roberts DM. Lithium Poisoning. J Intensive Care Med. 2017;32(4):249-263.

Hedya SA, Avula A, Swoboda HD. Lithium Toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 2022.

McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-728.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!

Avsnitt(1150)

Podcast 999: Right vs Left Internal Jugular Access

Podcast 999: Right vs Left Internal Jugular Access

Contributor: Travis Barlock, MD Educational Pearls: What is an internal jugular catheter (IJ) and when do we use it? IJs are catheters that can be placed in either the left or the right internal jugu...

23 Mars 2min

Podcast 998: Delayed Intubation After an Overdose

Podcast 998: Delayed Intubation After an Overdose

Contributor: Aaron Lessen, MD Educational Pearls: How long do we need to watch patients with a presumed overdose who were treated with naloxone in the field? A 2025 study in the Annals of Emergency M...

16 Mars 3min

Podcast 997: D-Dimer

Podcast 997: D-Dimer

Contributor: Travis Barlock, MD Educational Pearls: D-dimer: fibrin degradation product used to evaluate for clot formation and breakdown Threshold: Elevated D-dimer indicates recent or ongoing int...

9 Mars 2min

Podcast 996: Melatonin

Podcast 996: Melatonin

Contributor: Taylor Lynch MD Educational Pearls: Melatonin is an endogenous hormone released primarily by the pineal gland Also released by extrapineal regions in the retina, the GI tract, and some ...

2 Mars 4min

Episode 995: UTI Diagnosis

Episode 995: UTI Diagnosis

Contributor: Travis Barlock, MD Educational Pearls:  Foul-smelling urine and cloudy urine are commonly misinterpreted as indicators of a UTI. However, these findings alone are not diagnostic. Criteri...

24 Feb 5min

Podcast 994: Biphasic Anaphylaxis

Podcast 994: Biphasic Anaphylaxis

Contributor: Aaron Lessen, MD Educational Pearls: What is anaphylaxis and what are its treatments?  Anaphylaxis is a broad term for potentially life threatening allergic reactions that can progress t...

16 Feb 3min

Podcast 993: Personalized Gene Editing Therapy

Podcast 993: Personalized Gene Editing Therapy

Contributor: Alec Coston, MD Educational Pearls: Disclaimer: this has nothing to do with the ER but is too cool to not talk about. Condition: Carbamoyl phosphate synthetase 1 (CPS1) deficiency Ra...

9 Feb 6min

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Contributors: Travis Barlock MD, Ian Gillman PA, Jacob Altholz MD, Jeffrey Olson MS4 In this episode, EM attending Travis Barlock and medical student Jeffrey Olson listen in to the two remaining cases...

4 Feb 41min

Populärt inom Vetenskap

svd-nyhetsartiklar
dumma-manniskor
p3-dystopia
kapitalet-en-podd-om-ekonomi
allt-du-velat-veta
rss-ufo-bortom-rimligt-tvivel-2
rss-vetenskapsradion
doden-hjarnan-kemisten
rss-vetenskapsradion-2
det-morka-psyket
paranormalt-med-caroline-giertz
sexet
rss-odla
rss-spraket
bildningspodden
rss-experimentet
medicinvetarna
dumforklarat
har-vi-akt-till-mars-an
barnpsykologerna