Whole bowel irrigation (only for extended release tablets)
Gastric lavage and activated charcoal not effective and potentially harmful
Average patient has Na/volume deficit; giving fluid helps reestablish normal renal<unk>  excretion
Give 2L NS bolus, then start 200mL/hr or 2x maintenance rate
Most effective method of removal. Must follow serial<unk>  levels - levels will likely rise after HD due to redistribution from tissues; additional HD may be required.
Indications:
Kidney function is impaired and the [Li+] >4.0 mEq/L (1D recommendation)
Clinical deterioration
In the presence of a decreased level of consciousness, seizures, or life-threatening dysrhythmias irrespective of [Li+] (1D)
[Li+].>5.0 mEq/L (2D suggestion)
If the expected time to obtain a [Li+]<1.0 mEq/L with optimal management is >36 h (2D suggestion)
Baseline renal failure
Contraindication to aggressive fluid resuscitation (CHF, etc)
Make final decision after consulting toxicologist and/or nephrologist since it's a complex decision
Lithium toxicity
Aluminum toxicity
Antipsychotic toxicity
Antimony toxicity
Gamma hydroxybutyrate withdrawal
Arsenic toxicity
Benzodiazepine toxicity
Barium toxicity