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E.l is a 35-year-old 65kg white male being treated for acute mania. he is receiving 300mg lithium carbonate 3 time daily. His serum creatinine concentration is 0.9mg/dl. Calculate the expected lithium concentration just before the morning dose on the forth day of therapy. Some parameters of lithium Bioavailability=100% Clearance of lithium=25% of creatinine clearance Vd=0.7L/kg Molecular weight of lithium= 73.9g/mol

Question

E.l is a 35-year-old 65kg white male being treated for acute mania. he is receiving 300mg lithium carbonate 3 time daily. His serum creatinine concentration is 0.9mg/dl. Calculate the expected lithium concentration just before the morning dose on the forth day of therapy. Some parameters of lithium Bioavailability=100% Clearance of lithium=25% of creatinine clearance Vd=0.7L/kg Molecular weight of lithium= 73.9g/mol

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Solution

To calculate the expected lithium concentration, we need to follow these steps:

  1. Calculate the creatinine clearance using the Cockcroft-Gault equation:

    Creatinine Clearance = [(140 - Age) x Weight in kg x (0.85 if female)] / (72 x serum creatinine)

    For E.l, the equation would be:

    Creatinine Clearance = [(140 - 35) x 65] / (72 x 0.9) = 97.22 mL/min

  2. Calculate the clearance of lithium, which is 25% of the creatinine clearance:

    Lithium Clearance = 0.25 x 97.22 = 24.305 mL/min

  3. Calculate the daily dose of lithium in moles:

    Daily Dose = 300 mg x 3 / 73.9 g/mol = 12.18 mmol

  4. Calculate the steady state concentration of lithium:

    Css = (Daily Dose / Lithium Clearance) / (1440 min/day) = (12.18 / 24.305) / 1440 = 0.35 mmol/L

Therefore, the expected lithium concentration just before the morning dose on the fourth day of therapy would be 0.35 mmol/L.

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