<prompt> What happens to lithium levels in blood when used with hydrochlorothiazide?Blood levels of lithium riseBlood levels of lithium decreaseBlood levels of hydrochlorothiazide riseBlood levels of hydrochlorothiazide fall  <response>: Refer: Katzungs Basic and Clinical Pharmacology, 10thedition,pg no: 244Thiazide diuretics act by inhibiting the NaCl channel of DCT resulting in increased solute loss in urine without affecting the negative free water clearance.This loss of solutes especially sodium is compensated by increased reabsorption in the PCT.Renal lithium excretion is affected by changes in the sodium balance.Drugs causing renal loss of sodium causes increased reabsorption of lithium in PCT.Eg: ACE inhibitors, AT2 receptor blockers, NSAIDS, Thiazides 