A client is to receive lithium therapy as part of the treatment plan for bipolar disorder. When reviewing the client's medication history, which agents would alert the nurse to the possibility that a decrease in the lithium dosage may be needed? Select al
A) Lisinopril
B) Hydrochlorothiazide
C) Indomethacin
D) Caffeine
E) Aspirin
Ans: A, B, C
Drugs such as lisinopril, hydrochlorothiazide, and indomethacin increase serum lithium concentrations and as such might necessitate a reduction of the lithium dosage. Caffeine increases lithium excretion, so the drug dosage may need to be increased. Aspirin, unlike other nonsteroidal anti-inflammatory drugs, does not decrease renal clearance of lithium or increase serum lithium concentrations.
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