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Lithium toxicity with dehydration — GPhC CRA MCQ

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HardCNS TherapeuticsLithium toxicity with dehydrationGPhC CRA

A 56-year-old man taking lithium carbonate presents with diarrhoea, tremor and increasing unsteadiness. His lithium level was stable last month and he asks for loperamide. What is the most appropriate action?

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Correct answer: E — Refer urgently for lithium level, renal function and clinical assessment

Diarrhoea and dehydration can precipitate lithium toxicity, and tremor with ataxia is concerning. Lithium level, renal function and electrolytes should be checked urgently. NSAIDs can increase lithium levels and should be avoided unless specifically advised.

Reference: BNF