WordNet

do forcibly; exert force; "Dont force it!"
(physics) the influence that produces a change in a physical quantity; "force equals mass times acceleration"
physical energy or intensity; "he hit with all the force he could muster"; "it was destroyed by the strength of the gale"; "a government has not the vitality and forcefulness of a living man" (同)forcefulness, strength
group of people willing to obey orders; "a public force is necessary to give security to the rights of citizens" (同)personnel
a group of people having the power of effective action; "he joined forces with a band of adventurers"
a powerful effect or influence; "the force of his eloquence easily persuaded them"
force into or from an action or state, either physically or metaphorically; "She rammed her mind into focus"; "He drives me mad" (同)drive, ram
impose urgently, importunately, or inexorably; "She forced her diet fads on him" (同)thrust
produced by or subjected to forcing; "forced-air heating"; "furnaces of the forced-convection type"; "forced convection in plasma generators"
forced or compelled; "promised to abolish forced labor"
made necessary by an unexpected situation or emergency; "a forced landing"
increased secretion of urine; if not due to increased liquid intake or to the action of a diuretic drug it can be a symptom of diabetes mellitus

PrepTutorEJDIC

〈U〉(物理的な)『力』,勢い;体力 / 〈U〉『暴力』,腕ずく / 〈C〉《集合的に》(共通の目的・活動のための)集団,隊 / 〈C〉《しばしば複数形で》『軍隊』,部隊 / 〈C〉(社会的)勢力;有力な人物 / 〈U〉(精神あるいは知性の)力 / 〈U〉『影響力』,効果 / 〈U〉(言葉の)意味,真意 / 〈人〉‘に'『強いる』,無理を言う / (…から)…‘を'力ずくで手に入れる《+『名』+『from』(『out of』)+『名』》 / …‘を'むりに押し出す / (容器などに)…‘を'むりに押し込む《+『名』+『into』+『名』》 / (人に)…‘を'『押しつける』《+『名』+『on』(『upon』)+『名』〈人〉》 / 〈植物〉‘を'促成栽培する
強いられた,強制的な / 強いて作った,不自然な

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/28 09:48:04」(JST)

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Forced diuresis (increased urine formation by diuretics and fluid) may enhance the excretion of certain drugs in urine and is used to treat drug overdose or poisoning of these drugs and hemorrhagic cystitis.^[1]

Diuretics[edit]

Main article: Diuretic

Most of the drugs are either weak acids or weak bases. When urine is made alkaline, elimination of acidic drugs in the urine is increased. The converse applies for alkaline drugs.

This method is only of therapeutic significance where the drug is excreted in active form in urine and where the pH of urine can be adjusted to levels above or below the pK value of the active form of drug. For acidic drugs, urine pH should be above the pK value of that drug, and converse for the basic drugs. It is because the ionization of acidic drug is increased in alkaline urine and ionized drugs cannot easily cross plasma membrane so cannot re-enter blood from kidney tubules. This method is ineffective for drugs which are strongly protein bound (e.g. tricyclic antidepressants) or which have a large apparent volume of distribution (e.g. paracetamol, tricyclic antidepressants).^[2]

Forced alkaline diuresis has been used to increase the excretion of acidic drugs like salicylates and phenobarbitone, while forced acid diuresis has been used to enhance the elimination of cocaine, amphetamine, quinine, quinidine, and strychnine when poisoning by these drugs has occurred.

For forced alkaline diuresis, a diuretic like furosemide is given intravenously and sodium bicarbonate is added to the infusion fluid to make blood and, in turn, urine alkaline. Potassium replacement becomes of utmost importance in this setting because potassium is usually lost in urine. If blood levels of potassium are depleted below normal levels, then hypokalemia occurs, which promotes bicarbonate ion retention and prevents bicarbonate excretion, thus interfering with alkalinization of the urine.^[3]

For forced acid diuresis, ascorbic acid (vitamin C) is used. Ammonium chloride has also been used for forced acid diuresis but it is a toxic compound.^{[citation needed]} Usually however, this technique only produces a slight increase in the renal clearance of the drug. Forced acid diuresis is rarely done in practice.^[4]

Forced alkaline diuresis is also recommended for rhabdomyolysis.^[5]

Other[edit]

Immersion diuresis is a type of diuresis caused by immersion of the body in water (or equivalent liquid). It is mainly caused by lower temperature and by pressure.

References[edit]

^ Chemotherapy and biotherapy guidelines and recommendations for practice. Oncology Nursing Society - Professional Association. 2001 (revised 2005 May; republished 2005 Dec). NGC:004665
^ Overdose
^ eMedicine - Toxicity, Barbiturate : Article by Rania Habal, MD
^ http://jack119.org/myxoops/jackdownloads/toxbook_singapore.pdf
^ NGC - NGC Summary

UpToDate Contents

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1. 毒物除去の強化 enhanced elimination of poisons
2. 造影剤誘発性腎症の予防 prevention of contrast induced nephropathy
3. 炎症性疾患におけるシクロホスファミドの全身毒性 general toxicity of cyclophosphamide in inflammatory diseases
4. 化学療法関連腎毒性および腎不全患者における用量調整 chemotherapy related nephrotoxicity and dose modification in patients with renal insufficiency
5. ヘム色素誘発急性腎障害（急性腎不全）の予防および治療 prevention and treatment of heme pigment induced acute kidney injury acute renal failure

English Journal

Are diuretics harmful in the management of acute kidney injury?

Ejaz AA, Mohandas R.Author information Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Florida, USA.AbstractPURPOSE OF REVIEW: To assess the role of diuretics in acute kidney injury (AKI) and their effectiveness in preventing AKI, achieving fluid balance, and decreasing progression to chronic kidney disease (CKD).
Current opinion in nephrology and hypertension.Curr Opin Nephrol Hypertens.2014 Jan 2. [Epub ahead of print]
PURPOSE OF REVIEW: To assess the role of diuretics in acute kidney injury (AKI) and their effectiveness in preventing AKI, achieving fluid balance, and decreasing progression to chronic kidney disease (CKD).RECENT FINDINGS: Diuretics are associated with increased risk for AKI. The theoretical advant
PMID 24389731

Forced diuresis with the RenalGuard system: Impact on contrast induced acute kidney injury.

Solomon R.Author information University of Vermont College of Medicine, USA; Fletcher Allen Health Care, USA. Electronic address: Richard.solomon@vtmednet.org.AbstractKidney injury following the administration of iodinated contrast media occurs particularly in patients with reduced kidney and cardiac function and when large doses of contrast are used. There is little compelling evidence that vasodilators and anti-oxidants prevent this injury. Most prevention trials have employed intravenous volume loading as a central strategy. However, the success of this approach depends upon maintaining euvolemia while producing a vigorous diuresis. A novel strategy for maintaining euvolemia and inducing a vigorous diuresis has been developed using the RenalGuard system. In this review; the mechanism of protective action is reviewed. The trials of the RenalGuard device are reviewed and future uses of the device are discussed.
Journal of cardiology.J Cardiol.2014 Jan;63(1):9-13. doi: 10.1016/j.jjcc.2013.10.001. Epub 2013 Nov 12.
Kidney injury following the administration of iodinated contrast media occurs particularly in patients with reduced kidney and cardiac function and when large doses of contrast are used. There is little compelling evidence that vasodilators and anti-oxidants prevent this injury. Most prevention tria
PMID 24239195

Short hydration in chemotherapy containing cisplatin (≥75 mg/m2) for patients with lung cancer: a prospective study.

Horinouchi H, Kubota K, Itani H, Taniyama TK, Nakamichi S, Wakui H, Kanda S, Nokihara H, Yamamoto N, Sekine I, Tamura T.Author information *Division of Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan. hhorinou@ncc.go.jp.AbstractOBJECTIVE: We previously reported that 22% of lung cancer patients experienced a Grade 2 or 3 elevation in creatinine after chemotherapy containing cisplatin. We conducted a Phase II trial to evaluate the safety and efficacy of short hydration.
Japanese journal of clinical oncology.Jpn J Clin Oncol.2013 Nov;43(11):1105-9. doi: 10.1093/jjco/hyt122. Epub 2013 Sep 4.
OBJECTIVE: We previously reported that 22% of lung cancer patients experienced a Grade 2 or 3 elevation in creatinine after chemotherapy containing cisplatin. We conducted a Phase II trial to evaluate the safety and efficacy of short hydration.METHODS: The major eligibility criteria included patient
PMID 24006505

Japanese Journal

低容量のドパミン投与により治療したクレゾール中毒の一例

榎戸正則,伊関憲,福家千昭 [他],佐多晶子,高橋徹也,林田昌子,清野慶子,篠崎克洋,大谷浩一,タカハシテツヤ,Enokido Masanori,Iseki Ken,Fuke Chiaki,Sata Akiko,Takahashi Tetsuya
山形大学紀要. 医学 : 山形医学 29(2), 63-69, 2011-08-15
クレゾールは50%石鹸液として用いられる消毒薬であり、服毒すると細胞毒性と溶液による腐食性で全身臓器を障害する。中毒の治療法は、クレゾールが主に腎排泄されるため、強制利尿が推奨されている。一方で大量輸液により肺水腫となりやすい。今回、クレゾールを誤飲したアルツハイマー型認知症の高齢者に輸液負荷に加えて低容量のドパミン投与により軽快した症例を経験したので報告する。【症例】72才の女性が、施設 …
NAID 110008614767

急性中毒の輸液 (今すぐに役立つ輸液ガイドブック) -- (急性期疾患の治療を目的とした輸液)

吉岡敏治
綜合臨床 58(-), 872-875, 2009-00-00
NAID 40016697152

Fenofibrate-Induced Acute Renal Failure Due to Massive Rhabdomyolysis after Coadministration of Statin in Two Patients

Unal Aydin,Torun Edip,Sipahioglu Murat Hayri,Tokgoz Bulent,Kaya Mehmet Gungor,Oymak Oktay,Utas Cengiz
Internal Medicine 47(11), 1017-1019, 2008
… Both patients were managed with cessation of the statin-fibrate combination, adequate fluid resuscitation and forced alkaline-mannitol diuresis. …
NAID 130000078660