Lithium Side Effects and Signs of Lithium Toxicity

Levels of advanced signs of toxicity of lithium

1.5 to 2 mEq/L

Levels of severe toxicity for Lithium

2 to 2.5 mEq/L

Expected lab values for lithium

<0.4 to 1 mEq/L (therapeutic level)

Levels of Early signs of toxicity for lithium

<1.5 mEq/L

Levels of EXTREME toxicity for lithium

>2.5 mEq/L Symptoms may progress rapidly; coma, cardiac dysrhythmia, peripheral circulatory collapse, proteinuria, oliguria, and death Interventions: In addition to the interventions previously mentioned, hemodialysis may be used in severe cases.

Signs of severe toxicity of Lithium

Ataxia, serious EEG changes, blurred vision, clonic movements, large output of dilute urine, tinnitus, seizures, stupor, severe hypotension, coma; death is usually secondary to pulmonary complications

Advanced signs of toxicity

Coarse hand tremor, persistent gastrointestinal upset, mental confusion, muscle hyperirritability, eletroencephalographic (EEG) changes, incoordination.

Expected Side effects of lithium

Fine hand tremor, polyuria, and mild thirst, mild nausea and genral discomfort; weight gain

Interventions for early signs of toxicity for lithium

Medication should be withheld, blood lithium levels measured, and dosage re-evaluated

Interventions for Advanced signs of toxicity of Lithium

Medication withheld; blood lithium levels measured, and dosage re-evaluated. No known antidote for lithium poisoning; gastric lavage

Early signs of toxicity of lithium

Nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness

Interventions for expected side effects of lithium

Symptoms may persist throughout therapy. These symptoms often subside during therapy. Give with food to decrease nausea. Weight gain may be helped with diet, exercise, and nutritional management.

Interventions for severe toxicity for Lithium

There is no known antidote for lithium poisoning. The drug is stopped, and excretion is hastened. If patient is alert, an emetic is administered. Otherwise, gastric lavage and treatment with urea mannitol, and aminophylline hasten lithium excretion.