Chisca

Many factors influence drug removal by dialysis, the major ones being the type of filter used in your facility, whether or not a drug is protein-bound or water-soluble, molecular size, and the sieving coefficient (rate it is removed) of a particular medicine. Yes, it's a lot of factors involved. Synthroid is protein bound, so it will not pass through the dialysis filter. So is dilantin and digoxin. Your pharmacist isn't particularly helpful, as most antibiotics will dialyze right out, at least with the F180 filters used in my institution. I participated in a study on Vancomycin in which we drew labs every 15 minutes, and it was nearly 100% gone at the end of even a 3-hour treatment. Pain medications are different because receptors in the body latch on to the drug, so although some may be removed by dialysis, the patient will still obtain relief. BP meds are held not because they are removed by dialysis but because it hinders fluid removal. As fluid is removed, BP drops. You also might want to ask one of the nephrologists if they would be willing to give a short in-service in your unit about drug removal by dialysis.