Drug Dosing in Renal Insufficiency - Philippine College of Physicians

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Renal handling of drugs • Renal excretion dependent on: Glomerular filtration rate (GFR) • Molecular size • Protein binding Tubular secretion • May compensate for decreased protein binding Tubular reabsoprtion • As rate of creatinine clearance (Cl Cr ) decreases, drugs dependent on tubular secretion are also excreted more slowly. • The Cl Cr is a reasonable estimate of GFR and the tubular capacity for drug excretion.
Renal handling of drugs in CKD • Decreased drug clearance • Prolonged plasma half-life of drugs • Accumulation of ‘active’ drug metabolites • Decreases in renal drug metabolism • Changes in drug distribution: protein binding
Page 1 and 2: Drug Dosing in Renal Insufficiency
Page 3 and 4: Objectives • Discuss the effects
Page 5 and 6: Drug Pharmacokinetics • Bioavaila
Page 7 and 8: Bioavailability in CKD • Drug abs
Page 9 and 10: Volume of distribution (V d ) in CK
Page 11 and 12: Drug Pharmacokinetics • Bioavaila
Page 13: Drug Pharmacokinetics • Bioavaila
Page 17 and 18: Mathematics of drug elimination •
Page 19 and 20: Approach to adjust drug dosage 1. O
Page 21 and 22: Estimation of GFR and Creatinine Cl
Page 23 and 24: Estimation of GFR in AKI • No est
Page 25 and 26: Prescribing for a patient with rena
Page 27 and 28: Calculating individualized regimen
Page 31 and 32: ke = 0.693 / T 1/2 Dtsch Arztebl In
Page 35 and 36: Dtsch Arztebl Int 2010; 107(37): 64
Page 38 and 39: Drug dosing considerations for CKD
Page 40 and 41: Drug level monitoring • Ensures t
Page 42 and 43: Drug dosing considerations for PD
Page 44 and 45: Key points • Monitoring drug leve
Page 46: References Am Fam Physician 2007; 7

Drug Dosing in Renal Insufficiency - Philippine College of Physicians

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