But all of these drugs that I have listed there can result in syncopal episodes, torsades have been reported and there also have been deaths reported. In this situation grapefruit juice actually down there at the bottom, has resulted in Q-t prolongation. Theophylline is affected both by inducers and inhibitors resulting in changes in serum concentrations, necessitating both or either dosage increases or decreases. Warfarin also is one of those drugs that can be significantly affected resulting in potential problems, potentially significant problems, for the patient. So close monitoring is needed.
Diuretics basically increase sodium resorption and lithium always follows sodium in the kidney.
If you wonder about lithium, just think about what happens to sodium and that s what happens to lithium. Also, with non-steroidal antiinflammatory agents, this is an example of indomethacin. This is a kind of confusing slide. The top curve here with the open circles is urinary lithium levels. The bottom line is plasma lithium levels, and this center section that is kind of striped is the time period that the patients received indomethacin.