Lithium should be stopped how many days before surgery a) 1 b) 2 c) 3 d) 4 Answer: 2 days Explanation: Lithium is used to treat bipolar affective disorders. It may potentiate the effect of depolarizing and competitive neuromuscular blocking agents. The clearance of lithium can be reduced and its toxicity increased by factors that cause negative fluid balance, negative sodium balance, and decreased glomerular filtration rate. Lithium should be discontinued 2-3 days before major surgery and resumed when renal function and electrolyte levels are stable. If serum levels are not in a toxic range, renal function is normal, and fluid electrolyte status is stable, lithium can be continued before minor surgery.