Dialyzable drugs: Difference between revisions

Latest revision as of 23:23, 27 February 2022

Background

Factors Influencing Dialyzability

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.

Common Dialyzable Drugs

Mnemonics BLISTMED and ISTUMBLED:

B - Barbiturates
L - Lithium
I - Isoniazid
S - Salicylates
T - Theophyline/Caffeine (both are methylxanthines)
M - Methanol, metformin
E - Ethylene glycol
D - Depakote, dabigatran
Others - Carbamezepine

References

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-The ability to successfully dialyze a drug depends on: molecular size, protein binding, volume of distribution, and plasma clearance.
+===Factors Influencing Dialyzability===
-===Molecular weight===
+'''Molecular weight'''
-smaller molecular weight substances will pass through the dialysis membrane more easily than larger molecular weights.
+*Smaller molecular weight substances will pass through the dialysis membrane more easily than larger molecular weights.
-===Protein Binding===
+'''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.
+*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===
+'''Volume of Distribution'''
-Drugs with large volumes of distribution usually due to lipid solubility and low plasma protein binding are poorly diliazable.
+*Drugs with large volumes of distribution usually due to lipid solubility and low plasma protein binding are poorly diliazable.
-===Plasma clearance===
+'''Plasma clearance'''
-Although plasma clearance may be beneficial, increasing plasma clearance will dcrease dialysis clearance.
+*Although plasma clearance may be beneficial, increasing plasma clearance will dcrease dialysis clearance.
-===Dialysis Flow Rates===
+'''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.
+*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.
 ==Common Dialyzable Drugs==
-B - [[Barbiturate toxicity|Barbiturates]]
+''Mnemonics BLISTMED and ISTUMBLED:''
-L - [[Lithium Toxicity|Lithium]]
-I - [[INH Toxicity|Isoniazid]]
+*B - [[Barbiturate toxicity|Barbiturates]]
+*L - [[Lithium Toxicity|Lithium]]
+*I - [[INH Toxicity|Isoniazid]]
+*S - [[Aspirin (Salicylate) Toxicity|Salicylates]]
+*T - [[Theophylline toxicity|Theophyline]]/[[Caffeine toxicity|Caffeine]] (both are methylxanthines)
+*M - [[Methanol Toxicity|Methanol]], [[metformin]]
+*E - [[Ethylene glycol toxicity|Ethylene glycol]]
+*D - [[Depakote]], [[dabigatran]]
+*Others - [[Carbamazepine Toxicity|Carbamezepine]]
-S - [[Aspirin (Salicylate) Toxicity|Salicylates]]
-T - [[Theophylline toxicity|Theophyline]]/[[Caffeine toxicity|Caffeine]] (both are methylxanthines)
+*I - [[INH]]/[[isopropyl alcohol]]
+*S - [[Salicylates]]
+*T - [[Theophylline]]
+*U - [[Uremia]]
+*M - [[Methanol]]
+*B - [[Barbiturates]]
+*L - [[Lithium]]
+*E - [[Ethylene glycol]]
+*D - [[Dabigatran]], [[depakote]]
-M - [[Methanol Toxicity|Methanol]]
+==See Also==
+*[[Dialysis]]
+*[[In-Training Exam Review]]
-E - [[Ethylene glycol toxicity|Ethylene glycol]]
+==References==
+<references/>
-D - Depakote
-Others - [[Carbamazepine Toxicity|Carbamezepine]]
-==See Also==
-[[Complete dialyzable drugs chart]]
-[[Category:Tox]]
+[[Category:Toxicology]]