A Large Lithium Overdose with Unusual Pharmacokinetics
Bibliographic record
Abstract
Lithium has been used in psychiatry for 50 years and remains a first-line option for bipolar depression and mania. Approximately 7% of patients on lithium will develop toxicity at some point during their treatment. This can often be managed with isotonic crystalloid to promote excretion in the urine, but some patients will require hemodialysis. Here we present the case of a 66-year-old female who presented after ingesting 12 grams of immediate-release lithium. Twenty-eight hours after ingestion, her serum lithium began to rise despite adequate urine output and normal renal function. We hypothesized that this was due to delayed absorption from a pharmacobezoar formation, resulting in pharmacokinetics that mimics what was previously described to occur with sustained release formulations. This case exemplifies the importance of monitoring pharmacokinetic parameters in overdoses, as this can bring attention to issues of prolonged absorption. This has the potential to impact clinical decisions regarding hemodialysis or bowel decontamination.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".