Serum Lithium level is increased by all the following drugs EXCEPT
Correct Answer: Verapamil
Description: (D) Verapamil > Nonsteroidal antiinflammatory agents can facilitate renal proximal tubular resorption of Li+ and thereby increase concentrations in plasma to toxic levels.This interaction appears to be particularly prominent with indomethacin, but also may occur with ibuprofen, naproxen, and cyclooxygenase-2 (COX-2) inhibitors, and possibly less so with sulindac and aspirin . Most of the renal tubular reabsorption of Li+ occurs in the proximal tubule. Nevertheless, Li+ retention can be increased by any diuretic that leads to depletion of Na+, particularly the thiazides.Renal excretion can be increased by administration of osmotic diuretics, acetazolamide, or aminophylline, although they are of little help in the management of Li+ intoxication. Li+ often is used in conjunction with antipsychotic, sedative, antidepressant, and anticonvulsant drugs. There is, however, no absolute contraindication to the concurrent use of Li+ and psychotropic drugs.LITHIUM BLOOD LEVELSIncreased byDecreased by1. Thiazides1. Bronchodilators2. Tetracyclines2. Verapamil3. NSAIDs3. Carbonic anhydrase inhibitors
Category:
Pharmacology
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