Thomsen K, Schou M
Institute for Basic Psychiatric Research, Department of Biological Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Pharmacopsychiatry. 1999 May;32(3):83-6. doi: 10.1055/s-2007-979199.
To avoid lithium intoxications, clinicians should counteract conditions under which lithium clearance changes. If that is not possible, the lithium dosage should be adjusted to the lithium clearance. Lithium clearance is usually 20-30 per cent of the glomerular filtration rate and varies with it, for example during pregnancy and kidney disease. Lithium clearance may also change independently of the glomerular filtration rate. It decreases for example during dehydration (water deficiency) and low sodium intake, pathological conditions with edema formation, treatment with diuretics, anti-hypertensive drugs, or non-steroid anti-inflammatory drugs. It increases during treatment with some vasodilating drugs. Precautionary measures against lithium intoxication are suggested for each of these situations.
为避免锂中毒，临床医生应应对锂清除率发生变化的情况。若无法做到这一点，则应根据锂清除率调整锂的剂量。锂清除率通常为肾小球滤过率的20% - 30%，并随其变化，例如在妊娠和肾脏疾病期间。锂清除率也可能独立于肾小球滤过率而发生变化。例如在脱水（缺水）、低钠摄入、有水肿形成的病理状况、使用利尿剂、抗高血压药物或非甾体抗炎药物治疗期间，锂清除率会降低。在使用某些血管扩张药物治疗期间，锂清除率会升高。针对上述每种情况，均建议采取预防锂中毒的措施。
