Increased Lithium Dose Requirement in a Hyperglycemic Patient
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...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2002-03, Vol.36 (3), p.427-429 |
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| container_end_page | 429 |
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| container_issue | 3 |
| container_start_page | 427 |
| container_title | The Annals of pharmacotherapy |
| container_volume | 36 |
| creator | Cyr, Monica Guia, Melanie AC Laizure, S Casey |
| description | 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. |
| doi_str_mv | 10.1345/aph.1A227 |
| format | Article |
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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.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1345/aph.1A227</identifier><identifier>PMID: 11898805</identifier><identifier>CODEN: APHRER</identifier><language>eng</language><publisher>Cincinnati, OH: SAGE Publications</publisher><subject>Adult ; Biological and medical sciences ; Bipolar Disorder - drug therapy ; Blood Glucose ; Dose-Response Relationship, Drug ; Humans ; Hyperglycemia - metabolism ; Lithium - blood ; Lithium - pharmacokinetics ; Lithium - therapeutic use ; Male ; Medical sciences ; Metabolic Clearance Rate ; Neuropharmacology ; Pharmacology. Drug treatments ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology</subject><ispartof>The Annals of pharmacotherapy, 2002-03, Vol.36 (3), p.427-429</ispartof><rights>2002 SAGE Publications</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-8c09e9320f2f625f37ea6eba1c7c7e80baf106e227c8a6ffd1c5521bbe221b423</citedby><cites>FETCH-LOGICAL-c342t-8c09e9320f2f625f37ea6eba1c7c7e80baf106e227c8a6ffd1c5521bbe221b423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1345/aph.1A227$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1345/aph.1A227$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21817,27922,27923,43619,43620</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13572835$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11898805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cyr, Monica</creatorcontrib><creatorcontrib>Guia, Melanie AC</creatorcontrib><creatorcontrib>Laizure, S Casey</creatorcontrib><title>Increased Lithium Dose Requirement in a Hyperglycemic Patient</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>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.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Bipolar Disorder - drug therapy</subject><subject>Blood Glucose</subject><subject>Dose-Response Relationship, Drug</subject><subject>Humans</subject><subject>Hyperglycemia - metabolism</subject><subject>Lithium - blood</subject><subject>Lithium - pharmacokinetics</subject><subject>Lithium - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic Clearance Rate</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkDtPwzAQgC0EolAY-AMoC0gMKX7EiTMwVOXRSpVACGbLcc-tq7xqJ0P_PYZG6sJ0p7tP9_gQuiF4QljCH1W7mZAppdkJuiA8oXFKM3wacpziGFOBR-jS-y3GOCc0P0cjQkQuBOYX6GlRawfKwypa2m5j-yp6bjxEn7DrrYMK6i6ydaSi-b4Fty73Giqrow_V2dC6QmdGlR6uhzhG368vX7N5vHx_W8ymy1izhHax0DiHnFFsqEkpNywDlUKhiM50BgIXyoRTITyghUqNWRHNOSVFEUqkSCgbo_vD3NY1ux58JyvrNZSlqqHpvcwIJ4ynOIAPB1C7xnsHRrbOVsrtJcHy15UMruSfq8DeDkP7ooLVkRzkBOBuAJTXqjRO1dr6I8d4RgXjx-u8WoPcNr2rg4x_Nv4AIjh9Ug</recordid><startdate>20020301</startdate><enddate>20020301</enddate><creator>Cyr, Monica</creator><creator>Guia, Melanie AC</creator><creator>Laizure, S Casey</creator><general>SAGE Publications</general><general>Whitney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020301</creationdate><title>Increased Lithium Dose Requirement in a Hyperglycemic Patient</title><author>Cyr, Monica ; Guia, Melanie AC ; Laizure, S Casey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-8c09e9320f2f625f37ea6eba1c7c7e80baf106e227c8a6ffd1c5521bbe221b423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Bipolar Disorder - drug therapy</topic><topic>Blood Glucose</topic><topic>Dose-Response Relationship, Drug</topic><topic>Humans</topic><topic>Hyperglycemia - metabolism</topic><topic>Lithium - blood</topic><topic>Lithium - pharmacokinetics</topic><topic>Lithium - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic Clearance Rate</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cyr, Monica</creatorcontrib><creatorcontrib>Guia, Melanie AC</creatorcontrib><creatorcontrib>Laizure, S Casey</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cyr, Monica</au><au>Guia, Melanie AC</au><au>Laizure, S Casey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Lithium Dose Requirement in a Hyperglycemic Patient</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2002-03-01</date><risdate>2002</risdate><volume>36</volume><issue>3</issue><spage>427</spage><epage>429</epage><pages>427-429</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><coden>APHRER</coden><abstract>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.</abstract><cop>Cincinnati, OH</cop><pub>SAGE Publications</pub><pmid>11898805</pmid><doi>10.1345/aph.1A227</doi><tpages>3</tpages></addata></record> |
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| ispartof | The Annals of pharmacotherapy, 2002-03, Vol.36 (3), p.427-429 |
| issn | 1060-0280 1542-6270 |
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| source | MEDLINE; SAGE Complete |
| subjects | Adult Biological and medical sciences Bipolar Disorder - drug therapy Blood Glucose Dose-Response Relationship, Drug Humans Hyperglycemia - metabolism Lithium - blood Lithium - pharmacokinetics Lithium - therapeutic use Male Medical sciences Metabolic Clearance Rate Neuropharmacology Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology |
| title | Increased Lithium Dose Requirement in a Hyperglycemic Patient |
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