Saturday, June 2, 2012

Urine alkalinisation

1. Salicylate poisoning
- recommended in all symptomatic patients with regard of hypokalemia (common in salicylate poisoning)
- Diamox should NEVER be used as for acidemia and subsequent increased toxicity
- Urinary alkalinization by PO NaHCO3 enhances the elimination of weak acids: salicylates, phenobarbital, chlorpropamide, chlorophenoxy herbicides, formic acid, and methotrexate

2. Pure uric acid stones
- dissolved with oral alkalinization, K citrate, Na bicarbonate --> urinary pH 6.5-7

3. Rhabdomyolysis
- IV bicarbonate

4. Hemoglobinuria (heatstroke)

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