A client who has been taking lithium carbonate 300 mg tid comes to the Outpatient Department with a list of medications he is taking. Which of the medications on the list would require reevaluation of lithium dosage?
1. HydroDIURIL daily
2. Navane bid
3. Ativan at bedtime
4. Cefobid daily
ANS: 1
Diuretics alter fluid and electrolyte balance, increasing risk for lithium toxicity; therefore option 1 is correct. Antipsychotic medications are frequently prescribed concurrently with lithium to manage acute symptoms of mania, so no reevaluation of lithium dose is necessary for option 2. Antianxiety drugs are not contraindicated with concurrent lithium use, so no lithium dose reevaluation is necessary for option 3. Antibiotics do not alter fluid and electrolyte balance, so readjustment of lithium dosage is not required for option 4.
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