Adverse Effects, Interactions & Toxicity

Recognize hallmark toxicity presentations, since these are tested repeatedly: lithium toxicity (narrow therapeutic range — nausea, coarse tremor, confusion, progressing to seizures; maintaining adequate and consistent sodium/fluid intake is essential since dehydration or low sodium raises lithium levels dangerously). Aminoglycoside toxicity (ototoxicity and nephrotoxicity — monitor hearing and renal function/trough levels). Acetaminophen overdose (hepatotoxicity — N-acetylcysteine is the antidote). Magnesium sulfate toxicity (loss of deep tendon reflexes, respiratory depression — calcium gluconate is the antidote, covered further in maternal care).