คำอธิบาย
NSAIDs markedly increase lithium plasma levels, potentially causing lithium toxicity (tremor, ataxia, confusion, cardiac arrhythmias).
กลไก
Lithium is renally excreted in parallel with sodium; NSAID-induced sodium retention reduces renal lithium clearance, raising serum lithium to potentially toxic levels.
ความสำคัญทางคลินิก
Lithium levels can increase 15–66% within days of NSAID initiation; toxicity at levels >1.5 mEq/L can cause irreversible neurological damage.
การจัดการ
Avoid NSAIDs in lithium-treated patients; use acetaminophen for pain. If NSAID is essential, check lithium levels within 3–5 days and adjust dose. Sulindac may be safer (less effect on renal prostaglandins).
ข้อจำกัดความรับผิดชอบทางการแพทย์
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.