Monday, 25 October 2010

MRCP revision battle 34.6: Haemodialysis in overdose

Haemodialysis is not helpful in removing a drug if:
  • the drug has a large volume of distribution (eg amiodarone, paraquat)
  • the drug is highly protein-bound (digoxin, phenytoin)

The drugs that are appropriate for haemodialysis can be remembered as BLAST:
  • Barbituates
  • Lithium
  • Alcohol (methanol/ethanol)
  • Salicylate
  • Theophylline

Charcoal haemoperfusion may be considered for:
  • paracetamol
  • theophylline

Now for a touch of cyanide poisoning....