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What are the Non-extracorporeal methods of enhanced toxin elimination?
1. Multi-dose activated charcoal {MDAC} : "gastrointestinal dialysis"
2. peritoneal dialysis
List the extracorporeal methods of enhanced toxin elimination.
1. Haemodialysis [HD]
2. Haemoperfusion [HP]
3. Exchange Transfusion
4. Continuous veno-venous Haemofiltration [CVVH}
5. CAVH
Mnemonic for Toxins eliminated by Haemodialysis and Haemoperfusion?
" COP, I'VE STUMBLED"
COP I'VE STUMBLED ?
Carbamazepine
Osmol Gap [increased]
Propylene glycol

Isopropanol
Valproate ***
Excess Acid = [severe metabolic acidosis]

Salicylates ***
Theophylline
Uraemia [nephrotoxic drugs]
Methanol ***
Barbituates
Lithium ***
Ethylene Glycol ***
Diethylene / triethylene glycols
2 Mechanisms for MDAC?
1. Interrupts enterohepatic circulation for liver metabolised drugs
2. assists gastrointestinal mucosa to work as a "dialyser" : hence "gastrointestinal dialysis"
Which drugs in overdose can MDAC be used?
1. Carbamazepine
2. Phenytoin
3. Phenobarbitone
4. Theophylline
5. Dapsone
6. Piroxicam
7. Yellow Oleander