Lithium Side Effects and Signs of Lithium Toxicity

Severe toxicity 2 to 2.5 mEq/L

Ataxia, serious EEG changes, blurred vision, clonic movements, large output of dilute urine, tinnitus, blurred vision, seizures, stupor, severe hypotension, coma, death is usually secondary to pulmonary complications. Interventions: Drug is stopped, and excretion is hastened. If patient is alert, an emetic is administered. Gastric lavage and treatment with urea, mannitol, and aminophylline hasten lithium excretion.

Advanced signs of toxicity 1.5 to 2 mEq/L

Coarse hand tremor, persistant GI upset, mental confusion, muscle hyperirritability, EEG changes, incoordinaiton. Interventions: depending on severity.

Expected side effects of lithium (<0.4 to 1mEq/L (therapeutic level)

Fine hand tremor, polyuria, and mild thirst, mild nausea and general discomfort, weight gain Interventions: give with food to decrease nausea. weight gain may be helped with diet, excerise, and nutritional management.

Early Signs of Toxicity <1.5 mEq/L

N/V/D, thirst polyuria, slurred speech, muscle weakness Interventions: Medication should be with withheld, blood lithium levels measured, and dosage re-evaluated.

Severe toxicity >2.5 mEq/L

Symptoms may progress rapidly; coma, cardiac dysrhytmia, peripheral circulatory collapse, proteinuria, oligura, and death. Interventions: Hemodialysis