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Forced alkaline diuresis has been used to increase the excretion of acidic drugs like salicylates and phenobarbitone, and is recommended for rhabdomyolysis. [medical citation needed] For forced acid diuresis, ascorbic acid is sometimes used. Ammonium chloride has also been used for forced acid diuresis, but it is a toxic compound. [6]
A diuretic (/ ˌ d aɪ j ʊ ˈ r ɛ t ɪ k /) is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics increase the excretion of water from the body, through the kidneys ...
Since ibuprofen has acidic properties and is also excreted in the urine, forced alkaline diuresis is theoretically beneficial. However, because ibuprofen is highly protein-bound in the blood, the kidneys' excretion of the unchanged drug is minimal. Forced alkaline diuresis is, therefore, of limited benefit. [50]
Weak acids are excreted when the tubular fluid becomes too alkaline and this reduces passive reabsorption. The opposite occurs with weak bases. Poisoning treatments use this effect to increase elimination, by alkalizing the urine causing forced diuresis which promotes excretion of a weak acid, rather than it getting reabsorbed.
Ion trapping is the reason why basic (alkaline) drugs are secreted into the stomach (for example morphine), where pH is acidic, and acidic drugs are excreted in urine where the conditions are alkaline.
[1] [2] For thallium it may be used in addition to gastric lavage, activated charcoal, forced diuresis, and hemodialysis. [3] [4] It is given by mouth or nasogastric tube. [2] [4] Prussian blue is also used in the urine to test for G6PD deficiency. [5] Side effects may include constipation, low blood potassium, and stools that are dark.
In 1961 William E. Huckabee (1926–1986) described and defined the clinical problem of lactic acidosis. [7] [8] Cohen and H. Frank Woods introduced in 1976 what is now called the Cohen-Woods classification of the causes of lactic acidosis.
This diuresis leaves less water to be reabsorbed into the blood, resulting in a decrease in blood volume. [ citation needed ] A secondary effect of loop diuretics is to increase the production of prostaglandins , which results in vasodilation and increased blood supply to the kidney.