[Expert Solution]: Case #7: Patient HPI: Patient VT is a 57yr…

Case #7: Patient HPI: Patient VT is a 57yr old male who had a CT performed with contrast dye. The patient reports that they have been taking their newly prescribed lithium more than directed. The patient was experiencing lithium toxicity and lithium induced renal damage. What medication changes should be made based on current renal function? PMH: MDD, bipolar disorder, migraines, Drug allergies: NKDA Vital signs: Temp: 36.5◦C BP: 132/89 mmHg HR: 71 bpm RR: 18 br/min Height: 6’0” Weight: 144kg BMP: Sodium: 134mEq/L Potassium: 5.2mEq/L BUN: 21g/dL Creatinine: 2.55 mg/dL Glucose: 140mg/dL Calcium: 10.2mmol/L Chloride:104mEq/L Lithium levels: 2.4mEq/L Kidney calculations: Creatinine Clearance (ml/min) Weight used for CrCl Calculation (kg) Estimated GFR Calculator (ml/min/1.73m2) Medications: Current Medications Adjusted dose for renal function? (Y/N) *include new dose if applicable Discontinued for renal function What renal estimation did you use (CrCl or eGFR) Isotretinoin 20mg capsule 1cap po qd Fluoxetine 20mg 1tab po qd Lithium 300mg tid Ondansetron 4mg q8h prn N/V Sumatriptan 50mg PRN repeat in 2hrs MDD: 200mg Topiramate 100mg tab BID Butterbur Vitamin B12 400mg 1 tab po qd