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Lithium psychiatric medication adverse effect — ABEM Board MCQ

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ModeratePsychiatric emergenciesLithium psychiatric medication adverse effectABEM Board

A 55-year-old woman with bipolar disorder arrives with confusion and tremor after dehydration from gastroenteritis. Triage acuity is ESI 2; BP 104/66 mm Hg, HR 102/min. She takes lithium and lisinopril. Exam shows ataxia and coarse tremor. Which of the following is the most appropriate initial action?

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Correct answer: C — Check lithium level, renal function, and start IV hydration

Lithium toxicity is precipitated by dehydration and interacting drugs; ED care includes level, renal assessment, supportive hydration, and toxicology input if severe.

Reference: ACMT lithium poisoning guidance