Pharmacology · patient case question
Which analgesic is most appropriate for this patient?
Patient case: Patient with bipolar disorder and impaired renal function
Patient: Adult with bipolar affective disorder
Chief complaint: Attends for dental assessment.
Background: Bipolar disorder with depression, treated with lithium. Recent lithium overdose.
Vital signs / labs: Renal function reduced to 40% of normal.
Current findings: Multiple medications in use.
Show answer and explanation
Correct answer: B. Paracetamol (acetaminophen)
- A. Naproxen carries the same problems.
- B. CORRECT. Paracetamol avoids both the nephrotoxicity and the lithium interaction that make NSAIDs hazardous here. Dose adjustment for renal impairment may still be appropriate.
- C. Diclofenac likewise, with additional cardiovascular concerns.
- D. Ibuprofen is an NSAID: nephrotoxic and raises lithium levels.