WordNet
- a soft silver-white univalent element of the alkali metal group; the lightest metal known; occurs in several minerals (同)Li, atomic number 3
- the physiological state produced by a poison or other toxic substance (同)toxic condition, intoxication
- the act of giving poison to a person or animal with the intent to kill
PrepTutorEJDIC
- リチウム(金属元素;化学記号は『Li』)
UpToDate Contents
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English Journal
- A rare neurological complication due to lithium poisoning.
- Chan CH, Leung AK, Cheung YF, Chan PY, Yeung KW, Lai KY.SourceB6 Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong. stanchan01@yahoo.com.hk
- Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine.Hong Kong Med J.2012 Aug;18(4):343-5.
- Lithium salts have been used in treatment of depression and bipolar disorder for more than 50 years. Neurotoxic side-effects such as nystagmus, ataxia, tremor, fasciculation, clonus, seizure and even coma have been well described in the literature. We present a case of generalised peripheral neuropa
- PMID 22865182
- Higher requirements of dialysis in severe lithium intoxication.
- Lopez JC, Perez X, Labad J, Esteve F, Manez R, Javierre C.SourceIntensive Care Department, Renal Unit, Hospital Universitari de Bellvitge, Barcelona, Spain. juancarloslopezde@hotmail.com
- Hemodialysis international. International Symposium on Home Hemodialysis.Hemodial Int.2012 Jul;16(3):407-13.
- Severe lithium poisoning is a frequent condition in the intoxicated intensive care unit population. Dialysis is the treatment of choice, but no clinical markers predicting higher requirement for dialysis have been identified to date. We analyze the characteristics of lithium overdose patients needin
- PMID 22962699
Japanese Journal
- 糖尿病発症を契機に急性リチウム中毒に至った双極性障害の一例
- 石井 彰,菅原 斉,渡辺 珠美,吉川 修平,田代 研,石岡 春彦,深津 健,大沼 哲,牛木 真理子,讃井 將満,川上 正舒
- 自治医科大学紀要 33, 141-146, 2011-03-01
- 症例は双極性障害の31歳男性で炭酸リチウムにて治療中であった。主訴は意識障害。経過中口渇感を自覚し清涼飲料水を多飲するようになり,定期受診でHbA1c13%と高血糖であった。その後他院を受診し,尿ケトンが2+とケトーシスの状態で内服治療が開始となった。その9日後に意識障害が出現し昏睡状態に至ったため当センターへ緊急転院した。リチウム血中濃度は4.0mEq/Lと高値で救命はできたが後遺症として小脳失 …
- NAID 110008506977
- Detoxication Treatment for Carbamazepine and Lithium Overdose
- UNEI Hiroko,IKEDA Hiroaki,MURAKAMI Teruo,TANIGAWA Koichi,KIHIRA Kenji
- 藥學雜誌 128(1), 165-170, 2008-01-01
- … This article reports detoxication treatments of a case of combined overdose of carbamazepine and lithium in a 38-year-old female with bipolar disorder. … She was brought to the emergency unit after the family found her unresponsive and lying near empty packages for carbamazepine (corresponded to 7.7 g) and lithium carbonate (corresponded to 6.6 g) tablets. … The serum levels of carbamazepine and lithium approximately 5 h after ingestion were 56.0 μg/ml and 3.56 mEq/l, respectively. …
- NAID 110006533016
Related Links
- Acute toxicity occurs when you intentionally or accidentally swallow too much of a lithium prescription. ... Acute on chronic toxicity occurs when you take lithium every day for bipolar disorder, but one day you take an extra amount (as little as a ...
- 18 Nov 2010 ... Lithium Toxicity. Lithium has been in use since the 1870s.
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★リンクテーブル★
[★]
- 英
- lithium poisoning
- 同
- 炭酸リチウム中毒 lithium carbonate poisoning
概念
中毒と血中レベル
- 初期 1.5-2.5mEq/L 粗大振戦、失調、悪心、嘔吐、鎮静
- 中度 2.5-3.5mEq/L 耳鳴り
- 重度 3 -5 mEq/L 昏睡、血圧低下、 腎障害(慢性リチウム中毒で)
病態生理
- 低ナトリウム血症、NSAIDの投与 → 近位尿細管でのLi取り込み↑ → 血漿リチウム濃度上昇
- 悪心、嘔吐、下痢、腎不全、神経筋機能不全、失行、振戦、混乱(confusion)、昏迷(delirium、てんかん発作 → may require dialysis
- (筋細胞)血漿リチウム濃度↑ → K+の細胞内の移動が妨げられる → 再分極の阻害 → 高カリウム血症 → 突然死
- リチウム↑ → ADHやTSHのシグナル伝達系下流に存在するadenylyl cyclaseを阻害 → nephrogenic diabetes insipidus and ( hypothyroidism and/or goiter)
HIM.1808
病態
- リチウムの使用は慢性間質性腎症と関係があり、潜行性に慢性腎不全が進展する。
- 腎性尿崩症が単独で、あるいは腎不全を伴う
病理
- 尿細管の萎縮と間質の線維化が目立つ
- 尿細管の嚢胞(tubular cyst)
- 巣状硬化症/巣状分節状硬化症
徴候
- 多飲、多尿 ← リチウムは腎臓の集合管でADH受容体から下流を抑制するため
- 中等度蛋白尿と高カルシウム血症 ← リチウムによる副甲状腺機能亢進症による