General Measures in the Management of Acute Pesticide Poisoning

IV. Excretion of Absorbed Substances

A. Forced Diuresis
Forced diuresis is performed using 20% Mannitol at the following dose:

20% Mannitol
Test dose:
        Adult/Pedia: 200 mg/kg or 1 mL/kg within 10 min.
If with good urine output (>1mL/kg/hr), continue at initial dose of 0.5-1.0 g/kg or 2.5-5.0 mL/kg
Maintenance dose (if kidney function is good):
       Adult: 75-100 mL q 6 hours
       Pedia: 0.25-0.5 g/kg/dose or 1.0-2.5 mL/kg/dose q 6 hours
If diuresis does not occur in 2 hours, discontinue Mannitol. Duration of mannitol treatment will depend on the half-life of the ingested poison, but usually should not exceed 48 hours.

B. Dialysis and Hemoperfusion
These procedures are employed in cases of life-threatening poisoning such as paraquat and methyl bromide intoxications, electrolyte and acid base disturbances, and if the patient has underlying kidney or liver problems.
 
     
 
     
 
     
 
     
 
     
 
     
     
     
     
     
     
     
     
     
     
   

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