flushing medications??

Nurses General Nursing

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I am wondering if anyone can help me out. I am having a debate with other nurses about if it is really possible for a psychiatric patient to "flush out" their medications with water.

It is my position that this is really a myth, that while it technically can be done but in real life it is not happening even 1% of the time nurses claim it is happening

anyone who has any articles about this PLEASE PLEASE give links I really want to know, even if I am wrong

thanks in advance

frank

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Specializes in Nursing Home ,Dementia Care,Neurology..

Off the top of my head,if the chemical base of the drug is water soluable then I suppose it is possible but if the chemical links to fat then I don't see how it would flush.

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Specializes in Cardiology, Oncology, Medsurge.

Yes, I think you can! Especially Lithium (a salt) the more water you intake the more likely you'll micturate it out through your kidneys!

PS. Interestingly I had a patient who's admitting diagnosis was hyponatremia and when the MD made rounds stated that over hydration commonly occurs with the mentally ill. The man had a bipolar dx.

This website backs me up, http://www.diabetesinsipidus.org/4di_lithium.htm

Lithium is often given to patients with manic-depressive disorder (also sometimes called bipolar depression). It is usually very effective in such conditions, but can be toxic if the dose is not carefully monitored and controlled. Lithium can have a number of side effects, of which the most prominent are increased drinking (polydipsia) and increased urine production (polyuria). These occur because lithium interferes with the way the kidney responds to the hormone ADH, which normally controls our urine production.This makes it an acquired form of nephrogenic (kidney-related) diabetes insipidus (NDI).

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Off the top of my head,if the chemical base of the drug is water soluable then I suppose it is possible but if the chemical links to fat then I don't see how it would flush.

I posted this in two places and someone on the other thread mentioned lithium, but you are right about about water soluable vs fat. I will have to look up some of the drugs we use to make sure whether they are water soluable.

thanks

frank

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Yes, I think you can! Especially Lithium (a salt) the more water you intake the more likely you'll micturate it out through your kidneys!

PS. Interestingly I had a patient who's admitting diagnosis was hyponatremia and when the MD made rounds stated that over hydration commonly occurs with the mentally ill.

I forgot about lithium but when reading the blurb you put on the bottom of your post about lithium, is the normal restricting fluid due to wanting to protect against the side effect OR is the result of the side effect that the medication is being "flushed" and not effective?

I posted this in two different places and someone else mentioned how if the drug was water soluable, it probably is possible but if it is fat soluable then it probably is not possible. I will have to look into that.

I would also be curious about roughly how much water it would take and how soon after taking the meds.

thanks

frank

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Great question! I'm speculating that most nurses would be speculating. We're not physiopharmacologists (or whatever you'd call someone who would study pharmacokinetic and pharmacdynamics).

My speculation is that one might be able to reduce the overall dose received at a cellular level over time by drinking lots of water and "flushing out" the drug at a faster rate than is figured for when dosing the patient. I'd guess it could reduce the functional dosage by some fraction depending on the limits of kidney function and how the drug interacts with drug receptors, etc.

I'd imagine also that there'd be at least a few studies on this - that is the effects of overconsumption of water in an attempt to flush out a drug - that measure actual drug levels (and related metabolites) in the blood and urine relative to the amount of water consumed. Check out Pubmed and see if you can find anything on it!

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Hi can anyone help me I need to learn how to set an alaris pump, I am having trouble setting the VTBI , is there a formula i could use. I know if i am infusing 75ml/hr VTBI eill be 75, but I dont know how to figure out what to program for 1/2 hr, 15 mins etc. thanks any help would be appreciated

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Hi can anyone help me I need to learn how to set an alaris pump, I am having trouble setting the VTBI , is there a formula i could use. I know if i am infusing 75ml/hr VTBI eill be 75, but I dont know how to figure out what to program for 1/2 hr, 15 mins etc. thanks any help would be appreciated

I'm sorry, but maybe I'm not getting your question. Are you asking how to program a pump to deliver 75mls in 30 minutes when the pump asks how many mls/hr?

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Specializes in icu, er, transplant, case management, ps.

I take lithium. And occasionally my blood levels reach a toxic level. I have to go into the ER. And they plug me into an IV and run in a liter or two diluting my blood serum level and taking me out of toxic range. I've never tried drink a great deal of water to dilute my blood levels, so I can't say.

Woody:balloons:

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Duplicate threads merged.

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Hi can anyone help me I need to learn how to set an alaris pump, I am having trouble setting the VTBI , is there a formula i could use. I know if i am infusing 75ml/hr VTBI eill be 75, but I dont know how to figure out what to program for 1/2 hr, 15 mins etc. thanks any help would be appreciated

to run 75ml in 30 min, set vtbi at 150ml/hr.

to run 75ml in 15 min, set vtbi at 300ml/hr.

so to run in at half the time, double the volume.

to run in at qtr of time, quadruple the volume.

leslie

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I have looked around and i cannot find any articles one way or the other.

I do have a relative who is 38 takes lamictal, now she drinks a lot of water, not to "flush" the meds but because she likes it. She was a big water drinker long before taking the lamictal.

On avg she drinks about 80oz a day and when she does work out at the gym you can add about 30 more oz.

Now this is not done for psych reasons, it is actually a nuerological condition but she did ask her nuerologist about the possibility of her exercising causing the medications to metabalize faster than "normal" AND she asked them about her water comsumption and they told her it will not effect her medications.

That is one example and who knows maybe this guy was wrong. I want to somehow find an article about this.

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