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Forensic Medicine General 38b2fc36

Forced dieresis with acidification or alkalinization of urine is a common method for elimination of ceain poisons/ drugs from the body. The elimination of which of the following drugs is commonly enhanced by alkaline dieresis

A
Amphetamines
B
Phenobarbitone
C
Phencyclidine
D
Theophylline
High-Yield Explanation
B i.e. Phenobarbitone - Hemodialysis is not useful in copper sulfate, Kerosine oil, benzodiazepine, gganophosphate and digitalis poisoningQ. Mn "C-Oil BORD" Where hemodialysis is indicated in aspirin (salicylates), barbiturates (phenobarbitone), chloral hydrade, methyl & ethyl alcohol (ie methanol & ethanol), ethylene glycol and theophyllineQ. Charcol hemoperfusion is indicated in barbiturate (phenobarbitone)Q, carbamazepine and theophylline. - Multiple dose of activated charcoal to increase elimination by interrupting entero-enteric and entero-hepatic circulation is indicated in life threatening over dose with barbiturates (phenobarbitone), carbamazapine, theophylline, dapsone and quinineQ. - Forced alkaline dieresis (ie alkalinization of urine) is indicated in phenobarbitone and salicylates (eg aspirin)Q; whereas acid dieresis is indicated in amphetamine, phencyclidine & cocaine overdoseQ and saline diuresis in alcohol. - Most effective & rapid method of reducing plasma K+ level in hyperkalemia is hemodialysisQ (reserved for life threatening hyperkalemia unresponsive to conservative methods, in patients with renal failure). Peritoneal dialysis also works but is only 20% as effective as hemodialysis.

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