Hemodialysis is used in all poisoning except –
**Core Concept**
Hemodialysis is a treatment used to remove waste products, such as drugs and toxins, from the blood when the kidneys are unable to do so. It is particularly effective in treating poisoning by substances that are water-soluble and have a small molecular weight, allowing them to be easily cleared from the blood.
**Why the Correct Answer is Right**
Hemodialysis is effective in treating poisoning by substances such as lithium, ethylene glycol, and methanol, which are all water-soluble and have small molecular weights. The process of hemodialysis involves the use of a dialyzer, which is a semipermeable membrane that allows the removal of waste products from the blood. The effectiveness of hemodialysis in treating poisoning depends on the ability of the substance to cross the dialyzer membrane and be removed from the blood.
**Why Each Wrong Option is Incorrect**
**Option A:** Hemodialysis is not typically used in the treatment of barbiturate poisoning, as barbiturates are lipophilic and have a large volume of distribution, making them difficult to remove from the blood using hemodialysis.
**Option B:** Hemodialysis is not typically used in the treatment of digoxin poisoning, as digoxin is also lipophilic and has a large volume of distribution, making it difficult to remove from the blood using hemodialysis.
**Option C:** Hemodialysis is not typically used in the treatment of salicylate poisoning, as salicylates are also lipophilic and have a large volume of distribution, making them difficult to remove from the blood using hemodialysis.
**Clinical Pearl / High-Yield Fact**
When considering the use of hemodialysis in the treatment of poisoning, it is essential to remember that hemodialysis is most effective in treating poisoning by substances that are water-soluble and have small molecular weights. This is because these substances can easily cross the dialyzer membrane and be removed from the blood.
**Correct Answer: D.**