The effects of intravenous theophylline infusion versus intravenous sodium bicarbonate infusion on lithium clearance in normal subjects.
Ten normal subjects ingested lithium carbonate (600 mg p.o. b.i.d.) for three 1-week intervals. At the end of each weekly interval, subjects' lithium clearances were randomly perturbed for 12 hours with the subject in a supine position by infusing either normal saline (308 mEq), sodium bicarbonate (350 mEq) in normal saline (308 mEq), or theophylline (mean = 14.0 micrograms/ml) in normal saline (308 mEq). Subjects were placed on a 200 mEq/day sodium diet during the lithium clearance perturbation stages of the study. When each patient's normal saline lithium clearance was used as a control, it was found that the theophylline produced a significantly greater % increase in lithium clearance than did the sodium bicarbonate. Theophylline infusions increased patients' individual lithium clearances by 51 +/- 52%, while sodium bicarbonate infusions increased lithium clearances by 0.6 +/- 33%. Theophylline infusions ought to be investigated as an alternative to hemodialysis in lithium intoxications requiring the immediate reduction of lithium concentrations.
Holstad
S G
SG
College of Clinical Pharmacy, St. Louis College of Pharmacy, Washington University, MO.
Perry
P J
PJ
Kathol
R G
RG
Carson
R W
RW
Krummel
S J
SJ
D000328:Adult; D001639:Bicarbonates / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008094:Lithium / Q000493:pharmacokinetics* / Q000506:poisoning; D016651:Lithium Carbonate; D008297:Male; D008657:Metabolic Clearance Rate; D012964:Sodium / Q000494:pharmacology*; D017693:Sodium Bicarbonate; D013806:Theophylline / Q000494:pharmacology*
D001639:Bicarbonates; D016651:Lithium Carbonate; D017693:Sodium Bicarbonate; D008094:Lithium; D012964:Sodium; D013806:Theophylline