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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