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Lithium Toxicity

Symptoms: (Neurological findings appear late in acute ingestion, but are common presenting complaints in chronic toxicity.) Nausea Vomiting Diarrhea QTc prolongation (rare) Lethargy Ataxia Confusion Tremors, fasciculations, or myoclonic jerks Seizures Encephalopathy Nephrogenic Diabetese Insipidus (in chronic toxicity) Testing: Lithium level Therapeutic  lithium level is 0.8 – 1.2 mEq/L  (mmol/L) 1.5-2.5 mEq/L (mmol/L) – mild symptoms, chronic toxicity, tremor, slurred

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Toxidromes

US Poison Control Center Hotline 1-800-222-1222 Anticholinergic Syndrome Physiology:Inhibition of muscarinic cholinergic neurotransmission (blocking acetylcholine from binding receptors) gives these drugs their effect. Receptors are found on smooth muscle in the GI tract, bronchi, heart, salivary and sweat glands, the cilliary body of the eye, Drugs: antihistamines, sleep aids, tricyclic antidepressants, cold preparations, atropine, cyclopentalate (eye drops) Plants: deadly nightshade (belladonna), jimson weed Clinical Features: “Red as

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