A 55-year-old female with bipolar disorder has been stable o…
A 55-year-old female with bipolar disorder has been stable on lithium for several years. Recently, she developed influenza and began taking over-the-counter NSAIDs for body aches. Two days later, she presents to the emergency department with nausea, vomiting, tremor, confusion, and ataxia. Her family reports she has been increasingly lethargic and disoriented. Vital signs: BP 130/80 mmHg, HR 88 bpm, Temp 98.6°FLabs: Lithium level = 2.2 mEq/L (therapeutic range: 0.6–1.2 mEq/L)Renal function mildly impaired.
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