A patient 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 re-evaluation of lithium dosage?
a. HydroDIURIL daily
b. Navane bid
c. Ativan at bedtime
d. Cefobid daily
ANS: A
Diuretics alter fluid and electrolyte balance, increasing risk for lithium toxicity; therefore HydroDIURIL is correct. Antipsychotic medications are frequently prescribed concurrently with lithium to manage acute symptoms of mania, so no re-evaluation of lithium dose is nec-essary for Navane. Antianxiety drugs are not contraindicated with concurrent lithium use, so no lithium dose re-evaluation is necessary for Ativan. Antibiotics do not alter fluid and elec-trolyte balance, so readjustment of lithium dosage is not required for Cefobid.
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