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Effect of sodium polystyrene sulfonate on lithium bioavailability
D R Bélanger1, M G Tierney, G Dickinson
1Department of Pharmacy Services, Ottawa General Hospital, Ontario, Canada.
Study Objective:
To examine the effect of a single dose of sodium polystyrene sulfonate and sorbitol on lithium absorption.
Design:
Prospective, randomized, crossover.
Setting:
University teaching hospital.
Type Of Participants:
Healthy volunteers.
Interventions:
Subjects ingested 600 mg lithium carbonate on two occasions, with and without 30 g concomitant sodium polystyrene sulfonate. Blood samples were drawn up to 24 hours after ingestion and assayed for serum lithium concentration.
Measurements And Main Results:
Compared with control, sodium polystyrene sulfonate and sorbitol reduced the area under the lithium serum concentration-time curve by 11.33%, reduced the mean observed peak serum lithium concentration 0.07 +/- 0.08 mmol/L, and delayed the time to the mean observed peak serum lithium concentration by 2.04 +/- 2.40 hours.
Conclusion:
Sodium polystyrene sulfonate and sorbitol may be used in patients immediately or shortly after ingestion of a significant acute overdose of lithium in situations in which hemodialysis cannot be instituted promptly.