Enhanced Elimination Flashcards
1
Q
EE: IF
A
Severe toxicity
poor outcome despite supportive care & antidote
slow endogenous rate of elimination
Suitable pharmacokinetics
2
Q
EE techniques & amenable agents
A
MDAC: -carbamazepine -dapson -phenobarbitone -quinine -theophylline Urinary alkalinisation -phenobarbitone -salicylate Haemodialysis/ haemofiltration -lithium -metformin -Potassium -salicylate -theophylline -Toxic alcohol -valproic acid Charcoal haemoperfusion -theophylline
3
Q
MDAC:
A
- interrupts enterohepatic circulation
- GI dialysis
4
Q
MDAC: indications
A
Carbamazepine coma pheobarbitone coma Dapsone with methaemoglobinaemia Quinine Theophylline
5
Q
MDAC: absolute Contraindications
A
Decreased LCO
Bowel obstruction
6
Q
MDAC: Complications
A
vomiting charcoal aspiration constipation charcoal bezoar/ bowel obstruction/ bowel perforatin corneal abraision distracting staff from supportive care
7
Q
MDAC: technique
A
AC 1st dose PO 50 g or 1g/kg Repeat 1/2 dose q 2 hrly Check bowel sounds prior to each dose cease if absent bowel sounds reconsider clinical endpoints
8
Q
Urinary alkalinisation indications
A
Salicylate
Phenobarbitone
9
Q
CI
A
Fluid overload
10
Q
Complications
A
alkalaemia
Hypokalemia
Hypocalcaemia
11
Q
Technique
A
Correct hypokalemia NaHCO2 bolus 1-2 mmol/kg Infusion: 100mmol NaHCo3 in 1000ml 5% dex- 250ml/hr 20 mmol KCL to infusion R/v serum HCO3 & K q 4 hr End pt Urine pH > 7.5 Continue till clinical resolutino
12
Q
Extracorporeal techniques
A
toxic alcohol theophylline salicylate chronic lithium phenobarbitone metformin valproate carbamazepine KCl
