Gastric lavage may instead increase the severity of poisoning by dissolving the substance and enhancing its absorption. Big - Alcohol, ecstasy, amphetamines, anticholinergics, ß-blockers.Small - Opiates, organophosphates, other cholinergics.Reflexes down in CNS depressants up in anticholinergics and sympathomimetics.Ĭonvulsions – antichol, symp, CO, lithium, tricyclics, neuroleptics, alcohol withdrawal.Ĭoma unlikely in salicylates or paracetamol (unless liver failure). Myocardial depression – tricyclics, b blockers, Ca blockers. Incidence: Paracetamol > ibuprofen > aspirin > SSRIs > tricyclics.Īn acute overdose less than 10 times a single therapeutic dose seldom causes life-threatening symptoms apart from overdose with narcotics, paracetamol, lithium, digoxin and warfarin.Īrrythmias up to 24h if slow release preparation. Sodium administration, and the maintenance of high-normal sodium levels, may also reduce the severity of lithium toxicity by removing the dangerous intracellular fraction of lithium from inside excitable cells.Much of this is derived from the PACT module 'major intoxication'. Hemodialysis, and, to a lesser extent, peritoneal dialysis, will both rapidly eliminate lithium from the body. Initial general anti-poisoning measures, such as gastric lavage, may be helpful, but the ultimate success of treatment depends upon the elimination of lithium from the body. Moderate and severe toxicity both require more aggressive approaches. Mild toxicity can often be managed successfully with minimal intervention often only cessation or reduction of lithium doses is sufficient. Acute lithium toxicity is generally subdivided into three grades: mild, moderate, and severe.

Consequently recognition and treatment of lithium toxicity has also become more important. Although accurate epidemiological data is not available, it is generally agreed that acute lithium toxicity is becoming a more frequent problem.

Lithium toxicity antidote