title: Pharmacokinetics of lithium in plasma and red blood cells in acute and chronic intoxicated patients.
abstract: Lithium disposition in plasma, red blood cells (RBC) and urine was studied in acute self-poisoned patients upon chronic lithium therapy (n = 4) and in chronic intoxicated patients receiving oral lithium (n = 10). Following acute intoxication upon chronic lithium therapy, lithium pharmacokinetics did not differ from previous reports. Terminal plasma half-life ranged from 19.0-29.0 h and RBC/plasma ratio was 0.32 +/- 0.11. The distribution volume of the terminal phase, Vz, was estimated at 0.84 +/- 0.32 l/kg and renal clearance was 0.38 +/- 0.11 ml/mn/kg. After chronic intoxication lithium pharmacokinetics differed from those of the acute patients. Terminal plasma half-life ranged from 36.5-79.4 h and zero-order decline appeared in 8 of the 10 patients. The RBC/plasma ratio was 0.87 +/- 0.22 on admission. Vz was estimated at 0.71 +/- 0.27 l/kg and renal clearance was 0.16 +/- 0.07 ml/mn/kg. These modifications in lithium elimination kinetics could be related to the decrease in the glomerular filtration rate with age or renal dysfunction in this group of patients.
authors.affiliation: Département de Pharmacocinétique et Biomathématiques, Université Paris V, France.
authors.forename: G
authors.initials: G
authors.lastname: Ferron
authors.forename: M
authors.initials: M
authors.lastname: Debray
authors.forename: F
authors.initials: F
authors.lastname: Buneaux
authors.forename: F J
authors.initials: FJ
authors.lastname: Baud
authors.forename: J M
authors.initials: JM
authors.lastname: Scherrmann
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy; D062787:Drug Overdose; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006207:Half-Life; D006801:Humans; D008094:Lithium / Q000097:blood / Q000493:pharmacokinetics* / Q000506:poisoning* / Q000627:therapeutic use; D016651:Lithium Carbonate / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
chemical_list: D016651:Lithium Carbonate; D008094:Lithium