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Lithium toxicity risk — GPhC CRA MCQ

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HardCNS TherapeuticsLithium toxicity riskGPhC CRA

A 73-year-old woman taking lithium carbonate modified-release tablets attends with tremor, diarrhoea and unsteadiness after a week of poor oral intake from gastroenteritis. Her daughter says she also started ibuprofen for back pain. The next lithium dose is due this evening. What is the most appropriate action?

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Correct answer: E — Advise urgent medical assessment and withhold lithium until reviewed

Tremor, diarrhoea and ataxia are concerning for lithium toxicity, and dehydration plus NSAID use can raise lithium concentrations. This requires urgent clinical assessment and lithium level or renal function checks. The pharmacist should not manage this as a minor self-limiting illness.

Reference: BNF; NICE CKS