Differential diagnosis Occupational callosities, granuloma annulare and viral warts must be considered. Due to the hazards related to lithium, its use in any operational setting ought to be discouraged, and normally, the patient should be referred to a Medical Board. Patients in barbiturate coma need intensive monitoring and may require vasopressors to counteract arterial hypotension г‚їгѓЂгѓЄг‚№ SX 20mg г‚’г‚ўгѓЎгѓѓг‚Їг‚№гЃ§жіЁж–‡.