A patient was on lithium therapy for bipolar disorder for 6 months. She kept fast for few days due to religious reasons and presented with coarse tremors, abdmoninal pain, nausea, dizziness & confusion. Which of the following should be done to assess her condition?

This is a case of lithium toxicity so next best management is to measure lithium levels. Signs of Lithium toxicity Dehydration, low sodium diet, renal impairment- precipitates lithium toxicity Narrow TI (>1.5 mEq/dL) GI symptoms-Abdominal pain, vomiting CNS : Coarse tremors, ataxia, dysahria Muscle fasciculations, increased DTR, convulsions, impaired consciousness, death Management: Stop LITHIUM Correct dehydration Use of sodium polystyrene sulfonate or polyethylene glycol (to remove unabsorbed lithium from GI) Hemodialysis (in severe cases)