Forced acid diuresis

• Used for soluble basic drugs (e.g. amphetamines, quinine, phencyclidine)

• Furosemide or mannitol to maintain urine output >200ml/h

• Intravenous crystalloid to prevent hypovolaemia

• Avoid excessive positive fluid balance

• Use 750g NH4Cl in each 500ml 5% glucose to maintain urinary pH <7.0

• Alternate 0.9% saline with 5% glucose

• Monitor and replace potassium and magnesium carefully

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