Forced diuresis

Forced diuresis

Q. 1

In salicylate poisoning the treatment recommended is:

 A

Forced diuresis

 B

Chelating agent

 C

Atropine

 D

Conservation

Q. 1

In salicylate poisoning the treatment recommended is:

 A

Forced diuresis

 B

Chelating agent

 C

Atropine

 D

Conservation

Ans. A

Explanation:

A i.e. Forced diuresis


Q. 2

Alkaline diuresis is treatment of choice in poisoning with ‑

 A

Benzodiazepine

 B

Barbiturates

 C

Dhatura

 D

Morphine

Q. 2

Alkaline diuresis is treatment of choice in poisoning with ‑

 A

Benzodiazepine

 B

Barbiturates

 C

Dhatura

 D

Morphine

Ans. B

Explanation:

Ans. is ‘b’ i.e., Barbiturate poisoning

Elimination of poison from circulation can be by following methods :‑

A) Forced diuresis with or without alteration of urinary pH

  • Diuresis and ion trapping via alteration of urinary pH may prevent the renal reabsorption of poisons that under go excretion by glomerular filteration and active tubular secretion. Forced diuresis may be of following types :‑

1) Alkaline diuresis : Poisons which are trapped and excreted in alkaline urine are barbiturates (phenobarbitone), chlorpropamide, diffunisol, sulfonamides and salicylates.

2) Acid diuresis : It is done for amphetamines, cocaine, strychnine, phencyclidine, quinidine, quinine, chloroquine, TCA and tocainide.

3) Saline diuresis : It is useful for alcohol, thallium, bromide, lithium, fluoride, chromium, potassium and isoniazide.

B) Extracorporal removal therapies

  • These are peritoneal dialysis, hemodialysis, hemoperfusion (resin or charcol), hemofiltration, plasmapheresis and exchange transfusion. Commonly used procedures are :‑

1) Haemodialysis : It is useful in poisoning with alcohol (ethanol and methanol), aspirin (salicylates), acetone, atenolol, acetaminophen, barbiturates (phenobarbitone), bromide, boric acid, chloral hydrate, ethylene glycol, fluoride, lithium, trivalent arsenic, procainamide, theophylline, thiocyanate, sodium chlorate and sotalol. Hemodialysis is not useful in copper sulphate, benzodiazepines, organophosphates, kerosine and digitalis poisonings.

  • In all poisonings, where hemodialysis is indicated peritoneal dialysis is also used with one more indication of mercury poisoning.

2) Hemoperfusion (chorcol or resin) : It is used in acetaminophen, barbiturates carbamazepine, chloral hydrate, caffeine, CC14, chloramphenical, phenytoin, procainamide, salicylates, theophylline, valproate, dapsone and methotrexate.

Quiz In Between



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