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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.
Annals of Emergency Medicine
|November 1, 1992
Summary
Sodium polystyrene sulfonate and sorbitol significantly reduce lithium absorption after acute overdose. This combination may be a valuable alternative when hemodialysis is not promptly available.
Area of Science:
- Pharmacology
- Toxicology
- Internal Medicine
Background:
- Lithium is a mood stabilizer with a narrow therapeutic index.
- Acute lithium overdose can lead to serious toxicity.
- Prompt intervention is crucial to minimize lithium absorption.
Purpose of the Study:
- To evaluate the efficacy of sodium polystyrene sulfonate combined with sorbitol in reducing lithium absorption.
- To determine the impact of this intervention on serum lithium concentrations over time.
Main Methods:
- Prospective, randomized, crossover study conducted in a university teaching hospital.
- Healthy volunteers ingested lithium carbonate with and without sodium polystyrene sulfonate and sorbitol.
- Serum lithium concentrations were monitored for 24 hours post-ingestion.
Main Results:
- Sodium polystyrene sulfonate and sorbitol reduced the area under the lithium serum concentration-time curve by 11.33%.
- A decrease in mean peak serum lithium concentration was observed.
- The time to reach peak serum lithium concentration was delayed.
Conclusions:
- Sodium polystyrene sulfonate and sorbitol can effectively reduce lithium absorption following acute overdose.
- This intervention offers a potential alternative to hemodialysis in emergency situations.
- It may be particularly useful when rapid initiation of hemodialysis is not feasible.