Estimation of Lithium Dose Requirement by Lithium Clearance, Serum Lithium and Saliva Lithium following a Loading Dose of Lithium Carbonate

1981 ◽  
Vol 7 (3) ◽  
pp. 152-158 ◽  
Author(s):  
S.P. Tyrer ◽  
P. Grof ◽  
M. Kalvar ◽  
B. Shopsin
Keyword(s):  
Lithium Carbonate ◽  
Loading Dose ◽  
Lithium Clearance ◽  
Dose Requirement ◽  
Lithium Dose

scholarly journals Differential effects of 2C9*3 and 2C9*2 variants of cytochrome P-450 CYP2C9 on sensitivity to acenocoumarol

Blood ◽  
2002 ◽  
Vol 99 (11) ◽  
pp. 4237-4239 ◽  
Author(s):  
José Hermida ◽  
José Zarza ◽  
Ignacio Alberca ◽  
Ramón Montes ◽  
Marı́a Luz López ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Dose Group ◽  
Low Dose ◽  
High Dose ◽  
Loading Dose ◽  
Dose Requirement ◽  
Cytochrome P 450 ◽  
Reduced Risk ◽  
Medium Dose

The 2C9*3 and 2C9*2 polymorphisms of cytochrome P-450 CYP2C9 are associated with hypersensitivity to warfarin and bleeding. The effect of these polymorphisms on sensitivity to acenocoumarol is unknown. Three groups of patients, with low, medium, or high acenocoumarol-dose requirements, were studied. Age influenced the acenocoumarol sensitivity. Bearing the 2C9*3 allele was associated with the need for a lower acenocoumarol dose (odds ratio [OR], 6.02; 95% confidence interval [CI], 1.50-24.18); 80% of carriers of the 2C9*3 allele required a low dose. The 2C9*2 allele was associated with a lower acenocoumarol-dose requirement (OR, 2.70; 95% CI, 1.11-6.58) because of a reduced risk of the need for a high acenocoumarol dose (4.8% of the patients in the high-dose group carried the 2C9*2 allele versus 34.1% and 30.2%, respectively, in the medium-dose and low-dose groups). Therefore, carriers of 2C9*3 may need a low initial loading dose of acenocoumarol. Because acenocoumarol sensitivity with the 2C9*2 variant does not seem to be clinically relevant, the drug could be an alternative to warfarin in 2C9*2 carriers.

Estimation of lithium dose requirement by body weight

2002 ◽  
Vol 4 (4) ◽  
pp. 274-274 ◽  
Author(s):  
Mong-Liang Lu ◽  
Winston W Shen ◽  
Kun-Po Chen
Keyword(s):  
Body Weight ◽  
Dose Requirement ◽  
Lithium Dose

Effect of a single test dose of lithium carbonate on sodium and potassium excretion in man

1991 ◽  
Vol 81 (1) ◽  
pp. 59-63 ◽  
Author(s):  
D. G. Shirley ◽  
D. R. J. Singer ◽  
G. A. Sagnella ◽  
M. G. Buckley ◽  
M. A. Miller ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Plasma Concentrations ◽  
Test Dose ◽  
Lithium Carbonate ◽  
Placebo Control ◽  
Potassium Excretion ◽  
Lithium Clearance ◽  
Clearance Studies ◽  
Excretion Rates ◽  
Sodium And Potassium

1. The possible natriuretic and kaliuretic effects of a single dose of lithium, as used in lithium clearance studies, were investigated in 15 healthy subjects on fixed sodium (100 mmol/24 h) and potassium (70 mmol/24 h) intakes. Lithium carbonate (300 mg or 600 mg) or placebo tablets were administered, double-blind and in random order, midway through a 48 h urine collection (divided into six 8 h periods), at 23.00 hours. 2. During the three 24 h periods which preceded the administration of lithium or placebo (control days), rates of sodium and potassium excretion followed normal circadian patterns, but no differences in excretion rates between the 3 control days were observed. Placebo tablets did not affect excretion rates. 3. After the 300 mg dose of lithium carbonate, 24 h sodium excretion increased by approximately 17 mmol (P < 0.05); almost all of the natriuretic effect occurred during the first two 8 h periods. No effect on potassium excretion was observed. 4. After the 600 mg dose of lithium carbonate, 24 h sodium excretion increased by approximately 48 mmol (P < 0.001) and 24 h potassium excretion increased by approximately 19 mmol (P < 0.01). These effects were confined to the first two 8 h periods and thus occurred before and during the usual lithium clearance period. 5. Plasma renin activity, measured in 10 subjects, increased after the 600 mg dose of lithium carbonate (P < 0.005), but plasma concentrations of aldosterone and atrial natriuretic peptide were not significantly affected. Neither the 300 mg dose of lithium carbonate nor the placebo tablets affected hormone levels. 6. It is recommended that the test dose of lithium carbonate for use in lithium clearance studies should not exceed 300 mg.

Lithium als adjuvans bij een therapie-resistente depressie: een casus

1991 ◽  
Vol 3 (2) ◽  
pp. 30-33
Author(s):  
J. Dirkx
Keyword(s):  
Lithium Carbonate ◽  
Depressed Woman ◽  
Starting Dose ◽  
Lithium Dose

SummaryLithium was added to imipramine in case of a 55-year old depressed woman who didn't respond to imipramine alone. There was a clear improvement within a few days on 900 mg lithium carbonate a day (lithium plasmalevel 0.9 mmol/l). However when after two weeks the lithium dose was reduced to 600 mg a day (lithium plasmalevel 0.5 mmol/l), an almost immediate relapse followed. On resuming lithium in the old dose the depression disappeared again. After four weeks the second attempt at reducing and eventually stopping the lithium appeared to be successful. Half a year after cessation of lithium imipramine was also stopped. More than a year afterwards there hasn't been a depression again.In this case, after a fast potentiation of imipramine by lithium, a relapse followed when the lithium dose was reduced. It seems to be that even a high and successful starting dose of lithium needs to be continued for some time in order to prevent a relapse.

Increased Lithium Dose Requirement in a Hyperglycemic Patient

2002 ◽  
Vol 36 (3) ◽  
pp. 427-429 ◽  
Author(s):  
Monica Cyr ◽  
Melanie AC Guia ◽  
S Casey Laizure
Keyword(s):  
Blood Glucose ◽  
Plasma Concentration ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Plasma Concentrations ◽  
Dose Requirement ◽  
Lithium Plasma ◽  
Blood Glucose Concentrations ◽  
Persistent Hyperglycemia ◽  
Lithium Dose

OBJECTIVE: To report a case of apparent increased lithium clearance in a patient with persistent hyperglycemia. METHODS: Lithium doses, blood glucose concentrations, and lithium plasma concentrations were evaluated in a patient during a 53-day inpatient admission for exacerbation of bipolar disorder. The lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L was computed from the lithium dose and corresponding lithium plasma concentration. This value was correlated with the blood glucose concentration. RESULTS: A plot of the lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L versus the blood glucose concentration exhibited a direct linear relationship (r2 = 0.62). This plot indicates that higher lithium doses are needed during hyperglycemic states compared with euglycemic states to achieve equivalent plasma concentrations. CONCLUSIONS: Glycosuria associated with hyperglycemia induces an osmotic diuresis that increases the renal clearance of lithium, necessitating higher lithium doses to maintain therapeutic lithium plasma concentrations.

Lithium Carbonate Treatment of Alcoholism

1987 ◽  
Author(s):  
J. Fawcett ◽  
◽  
D. C. Clark ◽  
C. A. Aagesen ◽  
V. D. Pisani ◽  
...  
Keyword(s):  
Lithium Carbonate ◽  
Lithium Carbonate Treatment
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