Severe lithium toxicity may require which therapy?

Severe lithium toxicity may require which therapy?

• A. Hemodialysis
• B. Gastric lavage
• C. Peritoneal dialysis
• D. Plasma exchange

Answer: (A)

Severe lithium toxicity is best treated with hemodialysis because lithium is a small, water-soluble ion that is not significantly protein-bound and is cleared efficiently by dialysis. When toxicity is present—especially with renal impairment or pronounced neurologic symptoms—rapidly lowering the serum lithium concentration is crucial to prevent life-threatening effects like seizures, coma, or arrhythmias. Hemodialysis pulls lithium from the blood into the dialysate, providing much faster clearance than the kidneys alone. Because lithium can move back from tissues into the blood after dialysis ends, repeated or ongoing sessions may be necessary to prevent rebound. Gastric lavage is only useful if ingestion was extremely recent and not reliable for ongoing toxicity. Peritoneal dialysis removes lithium more slowly than hemodialysis and is typically not preferred when rapid clearance is needed. Plasma exchange doesn’t significantly help with lithium because it is not appreciably protein-bound, so it’s not effective for removing lithium.

Severe lithium toxicity is best treated with hemodialysis because lithium is a small, water-soluble ion that is not significantly protein-bound and is cleared efficiently by dialysis. When toxicity is present—especially with renal impairment or pronounced neurologic symptoms—rapidly lowering the serum lithium concentration is crucial to prevent life-threatening effects like seizures, coma, or arrhythmias. Hemodialysis pulls lithium from the blood into the dialysate, providing much faster clearance than the kidneys alone. Because lithium can move back from tissues into the blood after dialysis ends, repeated or ongoing sessions may be necessary to prevent rebound.

Gastric lavage is only useful if ingestion was extremely recent and not reliable for ongoing toxicity. Peritoneal dialysis removes lithium more slowly than hemodialysis and is typically not preferred when rapid clearance is needed. Plasma exchange doesn’t significantly help with lithium because it is not appreciably protein-bound, so it’s not effective for removing lithium.