Knowledge of route and extent of elimination of parent drugs or its active metabolites is critical to successful poison management
Drugs or toxicants with high molecular weights (MW ≥ 400 Da) or polycyclic are likely to be eliminated unchanged in the feces by biliary excretion. They may undergo enterohepatic circulation. Poison victims of such toxicants benefits from multiple doses of activated charcoal with a dose of saline laxative such as Mg/Na sulphate
In contrast,highly polar low molecular weight compounds are mostly excreted unchanged in urine. Their excretion is therefore enhanced by diuretics, manipulation of urinary pH , high fluid load . . .
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