Table 4.

Role of hemodialysis in the management of miscellaneous pharmacological poisonings.

Medication	Therapeutic use	Classic toxicity	Treatment	Efficacy of hemodialysis (HD)
Carbamazepine	Epilepsy Trigeminal neuralgia Bipolar disorder	Altered mental status Seizures Hemodynamic instability Arrhythmias	Supportive	May reduce carbamazepine level by about 50% [21–23]
Phenobarbital	Epilepsy	Altered mental status	Supportive	May reduce phenobarbital level by up to 59% after 4 h HD [24–26]
Phenytoin	Epilepsy Cardiac arrhythmias	Horizontal nystagmus Ataxia Altered mental status Arrhythmias Hypersensitivity reactions	Supportive	Should be considered in patients with severe poisoning not responding to supportive care [27]
Baclofen	Spasticity	Muscle hypotonia Altered mental status Hemodynamic instability	Supportive	Conventional HD can decrease the concentration by up to 79% [28–30]
Eptifibatide	Antiplatelet agent Acute coronary syndrome	Bleeding	Supportive Platelet transfusion	Limited to patients with renal failure experiencing ongoing severe bleeding not responding to supportive care [31]
Diltiazem Atenolol	Hypertension Cardiac arrhythmias	Bradycardia Hemodynamic instability	Supportive	HD may be considered in unstable patient with renal failure not responding to supportive care [32, 33]
Lisinopril	Hypertension Heart failure Renal disease	Acute kidney injury Hyperkalemia Hemodynamic instability Angioedema	Supportive	HD may be considered in unstable patient with renal failure not responding to supportive care [34]
Theophylline	Obstructive pulmonary disease	Arrhythmias Altered mental status Seizures	Supportive	HD may be considered in unstable patient with renal failure not responding to supportive care [35, 36]
Cefepime	Antibiotic	Neurotoxicity Altered mental status	Supportive	HD may be considered in unstable patient with renal failure not responding to supportive care [37]
Metronidazole	Antibiotic	Altered mental status Seizures Neuropathy Gastrointestinal symptoms	Supportive	HD should be considered in patient with metronidazole overdose and renal failure [38]
Dapsone	Antibiotic	Hypersensitivity reactions Methemoglobinemia	Supportive Methylene blue	HD should be considered in patients not responding to conventional therapy [39]
Isoniazid	Antibiotic	Neurotoxicity Seizures Liver toxicity	Supportive Pyridoxine	HD should be considered in patients not responding to conventional therapy [40]
Acetaminophen	Analgesic	Liver failure	Supportive N-Acetylcysteine Liver transplant	HD may be considered in unstable patients with metabolic acidosis [41]