Ever asked, “what the heck is an upper-level trough?” Let us explain
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Lithium has a very narrow therapeutic window, and small changes in kidney function or medications can quickly push levels into the toxic range. One of the most important clinical pearls is remembering the medications and conditions that reduce lithium clearance. A simple way to remember the major culprits is SALT. S – Sodium depletion: dehydration, vomiting, diarrhea, or low sodium intake cause the kidneys to conserve sodium. Because lithium is handled like sodium in the proximal tubule, the kid
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