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Published on: November 11, 2013
Lithium absorption prevented by sodium polystyrene sulfonate in volunteers
C Tomaszewski1, C Musso, J R Pearson
1Rocky Mountain Poison and Drug Center, Denver, Colorado.
Study Objective:
To determine if sodium polystyrene sulfonate prevents absorption of lithium in human beings.
Design:
Prospective, crossover study.
Type Of Participants:
Healthy volunteers age 22 to 34 years (three women and three men).
Interventions:
After an eight-hour fast, subjects ingested 0.5 mEq/kg (18.5 mg/kg) lithium carbonate. One hour later, they ingested either 857 mg/kg sodium polystyrene sulfonate in 4 mL water/g sodium polystyrene sulfonate (experimental) or an equal volume of water without sodium polystyrene sulfonate (control).
Measurements And Main Results:
Serum lithium levels were drawn zero, one, two, three, four, six, eight, ten, 12, and 24 hours after lithium ingestion. The sodium polystyrene sulfonate group had a smaller mean area under the serum concentration curve (11.6 +/- 1.0 mEq/L.hr versus 13.6 +/- 1.5 mEq/L.hr, P < .001) and lower mean highest measured lithium level (0.85 +/- 0.11 mEq/L versus 1.05 +/- 0.10 mEq/L, P < .05) compared with the control group. There was no significant difference in 24-hour urine lithium excretion or in serum sodium and potassium levels.
Conclusion:
Sodium polystyrene sulfonate administration decreased absorption of lithium after a lithium carbonate overdose. Sodium polystyrene sulfonate may be useful clinically for gastric decontamination after lithium overdoses.
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