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Intracorporeal and extracorporeal detoxification
Intracorporeal detoxification (enterosorption)
To bind toxins inside the body and then remove them, drugs are used that can adsorb low- and medium-molecular toxic agents on the surface of the active substance molecules. In the case of endogenous and exogenous intoxication, the use of such drugs has a generally positive, although not very pronounced effect.
The purpose of the event
Removal of exogenous and endogenous toxins from the body by adsorption in the gastrointestinal tract and bloodstream, followed by elimination in the urine and feces.
Indications
- Acute intoxication with psychoactive substances.
- Severe withdrawal states from psychoactive substances.
Contraindications
Intracorporeal detoxification is not used if there are contraindications to the use of a specific enterosorbent. For example, activated carbon is contraindicated in erosions, gastric ulcers, rheopolyglucin in anuria, acute heart failure, etc.
[ Description of enterosorbents
Based on chemical structure, drugs for intracorporeal detoxification include those based on coal, glucose polymers (cellulose, starch, dextran), polyvinylpyrrolidone (povidone) and silicic acid derivatives (enterosgel).
Sorbents in medicinal forms for oral administration are used in cases of acute intoxication with psychoactive substances taken orally (benzodiazepines, barbiturates, alcohol and its surrogates, opiates, cannabis preparations, etc.).
Intravenous drugs based on glucose dextrin polymer (rheopolyglucin) are prescribed for acute exogenous and endogenous intoxication of any etiology. These drugs are less effective if the toxin molecules are lipophilic (barbiturates, cannabinoids) or bound to transport proteins (butyrophenones, barbiturates and long-acting benzodiazepines such as phenobarbital and phenazepam).
Possible complications
Not marked.
Extracorporeal detoxification
The peculiarity of extracorporeal detoxification methods is the necessity of removing biological media (blood, plasma, cerebrospinal fluid) to cleanse them of toxins outside the body. An exception is peritoneal dialysis, traditionally attributed, however, to extracorporeal methods. To implement extracorporeal detoxification, sorption, membrane, gravitational, oxidative and photochemical blood processing technologies are used.