Forced alkaline diuresis
• Used for soluble acidic drugs (e.g. salicylates)
• Furosemide or mannitol to maintain urine output >200ml/h
• Intravenous crystalloid to prevent hypovolaemia
• Avoid excessive positive fluid balance
• Use 1.26% bicarbonate to maintain urinary pH >7
• Stop bicarbonate if arterial pH >7.5 and use 0.9% saline
• Alternate bicarbonate/saline with 5% glucose
• Monitor and replace potassium and magnesium carefully
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