Drug Dosing in Renal Insufficiency - Philippine College of Physicians

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Drug metabolism and drug handling in AKI • Changes in metabolism There are large gaps in knowledge of Delayed drug metabolism drug Variable metabolism effect on hepatic and metabolic disposition activity in patients with multiorgan dysfunction • Reduced drug clearance syndrome, multisystem organ failure Hypoxia and Decreased AKI; thus, protein synthesis patients are at risk of underdosing and overdosing. Competitive inhibition from medications Decreased hepatic perfusion
Mathematics of drug elimination • Total body drug clearance = Drug dose AUC • Renal clearance = Total amount of drug in urine Plasma drug concentration • Renal clearance rate = Clearance Sample collection time • T 1/2 = V d x 0.693 Drug clearance
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 15: Renal handling of drugs in CKD •
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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