Which substance should be held when a patient is taking lithium?

Which substance should be held when a patient is taking lithium?

• A. Acetaminophen
• B. Antibiotics
• C. NSAIDs
• D. Vitamin C

Answer: (C)

Lithium is cleared by the kidneys, so anything that lowers renal filtration can raise lithium levels and increase the risk of toxicity. Nonsteroidal anti-inflammatory drugs reduce prostaglandin production in the kidney, which lowers renal blood flow and glomerular filtration rate. With less filtration, lithium is cleared more slowly, causing its level in the blood to rise and toxicity symptoms to appear (like tremor, confusion, imbalance, and GI distress). Because of this, NSAIDs should be avoided or used with great caution in someone taking lithium, and safer alternatives such as acetaminophen are often preferred for pain. If an NSAID is absolutely necessary, closely monitor lithium levels and watch for signs of toxicity, and keep hydration and salt balance stable to help maintain consistent lithium levels.

Lithium is cleared by the kidneys, so anything that lowers renal filtration can raise lithium levels and increase the risk of toxicity. Nonsteroidal anti-inflammatory drugs reduce prostaglandin production in the kidney, which lowers renal blood flow and glomerular filtration rate. With less filtration, lithium is cleared more slowly, causing its level in the blood to rise and toxicity symptoms to appear (like tremor, confusion, imbalance, and GI distress). Because of this, NSAIDs should be avoided or used with great caution in someone taking lithium, and safer alternatives such as acetaminophen are often preferred for pain. If an NSAID is absolutely necessary, closely monitor lithium levels and watch for signs of toxicity, and keep hydration and salt balance stable to help maintain consistent lithium levels.