A patient was on lithium therapy for bipolar disorder for 6 months. She kept fast for few days due to religious reasons and presented with coarse tremors, abdmoninal pain, nausea, dizziness & confusion. Which of the following should be done to assess her condition?
This is a case of lithium toxicity so next best management is to measure lithium levels. Signs of Lithium toxicity Dehydration, low sodium diet, renal impairment- precipitates lithium toxicity Narrow TI (>1.5 mEq/dL) GI symptoms-Abdominal pain, vomiting CNS : Coarse tremors, ataxia, dysahria Muscle fasciculations, increased DTR, convulsions, impaired consciousness, death Management: Stop LITHIUM Correct dehydration Use of sodium polystyrene sulfonate or polyethylene glycol (to remove unabsorbed lithium from GI) Hemodialysis (in severe cases)
S. electrolyte
S. lithium levels
ECG
MRI
NEET Jan 2020