Diferencia entre revisiones de «Dialyzable drugs»
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==Background== | ==Background== | ||
The ability to successfully dialyze a drug depends on: molecular size, protein binding, volume of distribution, | The ability to successfully dialyze a drug depends on: molecular size, protein binding, volume of distribution, and plasma clearance. | ||
===Molecular weight=== | |||
smaller molecular weight substances will pass through the dialysis membrane more easily than larger molecular weights. | |||
===Protein Binding=== | |||
Drugs with a high degree of protein binding will have a small plasma concentration of unbound drug available for dialysis, making them poorly dialyzable or requiring multiple sessions. | |||
===Volume of Distribution=== | |||
Drugs with large volumes of distribution usually due to lipid solubility and low plasma protein binding are poorly diliazable. | |||
===Plasma clearance=== | |||
Although plasma clearance may be beneficial, increasing plasma clearance will dcrease dialysis clearance. | |||
===Dialysis Flow Rates=== | |||
Greater degrees of dialysis can be achieved with faster dialysate flow rates if the dialysate drug concentrations is low. As the concentration of drug is increased in the diasylate the flow rate needs to be lowered. | |||
B - [[Barbiturate toxicity|Barbiturates]] | B - [[Barbiturate toxicity|Barbiturates]] | ||
Revisión del 16:29 5 dic 2015
Background
The ability to successfully dialyze a drug depends on: molecular size, protein binding, volume of distribution, and plasma clearance.
Molecular weight
smaller molecular weight substances will pass through the dialysis membrane more easily than larger molecular weights.
Protein Binding
Drugs with a high degree of protein binding will have a small plasma concentration of unbound drug available for dialysis, making them poorly dialyzable or requiring multiple sessions.
Volume of Distribution
Drugs with large volumes of distribution usually due to lipid solubility and low plasma protein binding are poorly diliazable.
Plasma clearance
Although plasma clearance may be beneficial, increasing plasma clearance will dcrease dialysis clearance.
Dialysis Flow Rates
Greater degrees of dialysis can be achieved with faster dialysate flow rates if the dialysate drug concentrations is low. As the concentration of drug is increased in the diasylate the flow rate needs to be lowered. B - Barbiturates
L - Lithium
I - Isoniazid
S - Salicylates
T - Theophyline/Caffeine (both are methylxanthines)
M - Methanol
E - Ethylene glycol
D - Depakote
Others - Carbamezepine
Source
- University of Buffalo Emergency Medicine Inservice Review