Lithium is a soft, silver-white metal which belongs to the alkali metal group of chemical. It is used in the electrical and electronic devices, chemical and industrial components, nuclear industry, but also in for medical purposes.

In medicine it was used firstly to treat gout in the 19th century, but nowadays it is used to treat bipolar disorder, schizoaffective disorder and major depression. As any metal, lithium intake can have side effects, the most common being hand and muscle tremor, twitching, and hypothyroidism. In large dosage lithium can be highly toxic and can cause severe damage.

As with all toxic intakes, it is very important to determine the amount, time and reason for the intake. There are 3 categories of lithium poisoning:

-          Acute lithium poisoning with symptoms like nausea, vomiting, cramping, and sometimes diarrhea.  The progression of acute poisoning can determine neuromuscular signs like tremulousness, dystonia, hyperreflexia, and ataxia. 

-          Acute-to-chronic lithium poisoning occurs to patients that take lithium regularly and have taken recently a larger dose. The symptoms are: increasing confusion, blackouts, increased deep tendon reflexes, jerks, urinary or fecal incontinence, increasing restlessness

-          Chronic lithium poisoning has devastating effects like coma, convulsions, cardiac dysrhythmias, sino-atrial block, sinus and junctional bradycardia and first degree heart block, circulatory collapse and renal failure, hypotension or rarely hypertension.

There are some drugs that combine with lithium can cause intoxication. The responsible groups are:

-          Diuretics that cause renal sodium wasting

-          Angiotensin-converting enzyme (ACE) inhibitors that enhance the tubular reabsorption of lithium

-          Nonsteroidal anti-inflammatory drugs

The systemic effects of lithium are

-          Renal toxicity

-          Endocrine disorders

-          Leukocytosis

-          Edema

-          Dermatitis

-          Skin ulcers

The physical effects of lithium poisoning include:

-          Neurologic effects like tremors, lethargy, confusion, seizures, and coma

-          General effects like nausea, vomiting, abdominal pain and diarrhea.

The treatment for lithium poisoning is divided in two very important steps:

-          Pre-hospital actions like the stabilization of life-endangering conditions, the intravenous intake of isotonic sodium chloride solution, monitoring cardiac function to assess any rhythm disturbances

-          Hospital care with gastric lavage with charcoal, whole-bowel irrigation with polyethylene glycol, hemodialysis is indicated for patients with have renal failure and fluid therapy with saline administration

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