@article{ref1,
title="Unrecognized delayed toxic lithium peak concentration in an acute poisoning with sustained release lithium product",
journal="Southern medical journal",
year="2007",
author="Borrás-Blasco, Joaquín and Sirvent, Ana Esther and Navarro-Ruiz, Andrés and Murcia-López, Ana and Romero-Crespo, Isabel and Enriquez, Ricardo",
volume="100",
number="3",
pages="321-323",
abstract="A 32-year-old female with a history of bipolar disorder was admitted after taking approximately 16 g of an extended-release lithium carbonate formulation in an attempted suicide. Five hours after consumption, the lithium serum level was 3.2 mEq/L. Fourteen hours after consumption, the lithium level was 5.1 mEq/L and the patient was asymptomatic. Due to a level > 4 mEq/L, the patient was transferred to a renal medicine service for hemodialysis. The lithium concentration 6 hours after the hemodialysis was 2.54 mEq/L. Thirty seven hours after the consumption (15 hours after hemodialysis), lithium levels increased up to 6.09 mEq/L. A second hemodialysis session was performed, which successfully reduced the serum lithium concentration to 1.86 mEq/L. Lithium levels 85 hours after the consumption were 0.61 mEq/L and the patient was transferred to the Psychiatry Department. Unrecognized delayed toxic peak lithium concentration may appear in an acute poisoning with a sustained release lithium product. Therefore, patients presenting with acute intoxication with extended release formulations should be managed with caution, and continued drug monitoring is suggested.<p /><p>Language: en</p>",
language="en",
issn="0038-4348",
doi="10.1097/01.smj.0000257619.25995.c4",
url="http://dx.doi.org/10.1097/01.smj.0000257619.25995.c4"
}