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what are the clinical features of lithium at a therapeutic dose?
- fine tremor
- dry mouth
- GI disturbance
- increased thirst
- increased urination
- thyroid dysfunction (hypothyroidism)
- nephrotoxicity
what are the clinical features of lithium toxicity?
- coarse tremor
- CNS disturbance (seizures, ataxia, dysarthria)
- polyuria
- cardiac arrhythmias
- visual disturbance
what may precipitate lithium toxicity?
- dehydration
- renal failure
- drugs
which drugs can precipitate lithium toxicity?
- diuretics (thiazides)
- ACEi/ARBs
- NSAIDs
- metronidazole
what is the management of mild-moderate lithium toxicity?
volume resuss with normal saline
what may be needed in severe toxicity with poor renal function?
haemodialysis