Lithium carbonate is used to treat depressive episodes in patients with manic
depressive disorder.
Lithium toxicity is closely related to serum levels of
lithium, and can occur with doses of
lithium carbonate close to those used in
therapy. Herein we report a case in which
pharmaceutical intervention led to a patient's early recovery. The patient was hospitalized with a complaint of
dyspnea, and clinical findings revealed signs of
bradyarrhythmia. We investigated the medications the patient brought with him and the record of his prescribed medications in his
drug notebook. From this we found that he had been taking
imidapril (an
angiotensin-converting enzyme inhibitor) in addition to
lithium carbonate, and surmised that
lithium toxicity may have occurred from the drug interactions between the
lithium carbonate and
imidapril in this patient. To prevent the level of toxicity from advancing, we proposed to the physician in charge that the patient's serum
lithium levels be measured immediately and that all drugs be discontinued. By receiving care centered on detoxification, the patient avoided measures such as placement of a permanent pacemaker and thereby made a quick recovery from a dangerous state. This is a good example of a case in which
pharmaceutical intervention improved the patient's quality of life (QOL) and contributed to conserving limited medical resources. As shown by this case, regular checks of patients' current medications and
drug notebooks at the time of hospitalization are an effective means of implementing
pharmaceutical interventions that can contribute to medical care.