Therapeutic plasma exchange (TPE) is an extracorporeal process in which a large volume of whole blood is taken from the patient's vein. Plasma is then separated from the other cellular components of the blood and discarded while the remaining blood components may then be returned to the patient. Replacement fluids such as albumin or fresh-frozen plasma may or may not be used. TPE has been used clinically for the removal of pathologic targets in the plasma in a variety of conditions, such as pathogenic antibodies in autoimmune disorders. TPE is becoming more common in the neurointensive care space as autoimmunity has been shown to play an etiological role in many acute neurological disorders. It is important to note that not only does TPE removes pathologic elements from the plasma, but may also remove drugs, which may be an intended or unintended consequence. The objective of the current review is to provide an up-to-date summary of the available evidence pertaining to drug removal via TPE and provide relevant clinical suggestions where applicable. This review also aims to provide an easy-to-follow clinical tool in order to determine the possibility of a drug removal via TPE given the procedure-specific and pharmacokinetic drug properties.

中文翻译：

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接受治疗性血浆交换的患者的药物剂量。

治疗性血浆置换 (TPE) 是一种体外过程，其中从患者的静脉中抽取大量全血。然后将血浆与血液的其他细胞成分分离并丢弃，而剩余的血液成分然后可以返回给患者。可以使用或不使用白蛋白或新鲜冷冻血浆等替代液。TPE 已在临床上用于去除各种条件下血浆中的病理靶点，例如自身免疫性疾病中的致病性抗体。TPE 在神经重症监护领域变得越来越普遍，因为自身免疫已被证明在许多急性神经系统疾病中发挥着病因学作用。需要注意的是，TPE 不仅可以去除血浆中的病理成分，还可以去除药物，这可能是有意或无意的后果。当前审查的目的是提供有关通过 TPE 去除药物的可用证据的最新摘要，并在适用的情况下提供相关的临床建议。本综述还旨在提供一种易于遵循的临床工具，以确定特定程序和药代动力学药物特性通过 TPE 去除药物的可能性。