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Decontamination and enhanced elimination of poisons 

Decontamination and enhanced elimination of poisons
Chapter:
Decontamination and enhanced elimination of poisons
Author(s):

Darren M. Roberts

DOI:
10.1093/med/9780199600830.003.0316
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date: 24 February 2020

Decontamination and enhanced elimination are treatments that may be administered to patients with acute poisoning. They should not be used routinely in any patient, but initiated on a case-by-case basis after consideration of the type of poison, amount and time since exposure, anticipated clinical benefit, and other factors. Decontamination aims to decrease the severity and potential duration of poisoning. Activated charcoal is the most common form used and should be administered within 1–2 hours of poison ingestion. Enhanced elimination aims to decrease the duration and other consequences of poisoning. It is most commonly used for in severe poisoning with an agent that has a long elimination half-life. Elimination of a poison can be enhanced with extracorporeal therapies, multiple doses of activated charcoal, sodium polystyrene sulphate, and urinary alkalinization, although data support their use in selected cases only. To maximize poison clearance by haemodialysis or haemofiltration, the prescribed regimen may differ to that used for renal replacement therapy.

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