Use of Drugs in Uremia and Dialysis View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1998

AUTHORS

D. Craig Brater

ABSTRACT

A host of drugs are eliminated by the kidney and thereby require dose adjustment in patients with renal insufficiency (1–5). In addition, some drugs that themselves are not dependent upon the kidney for excretion are converted in the liver to active metabolites that accumulate in patients with diminished renal function (6,7). Examples include Nacetyl procainamide and normeperidine, the metabolites of procainamide and meperidine, respectively. These compounds can accumulate to toxic concentrations in patients with renal insufficiency. To avoid toxicity from either parent drug or active metabolites, doses of many drugs must be adjusted downward in patients with decreased renal function. The precision required in this dose adjustment is not always great and depends upon the therapeutic index of individual drugs. For example, penicillins and cephalosporin antibiotics have wide margins of safety. Many antibiotics in these classes are administered in smaller doses to patients with severe renal insufficiency, but this administration does not require the same degree of precision as dose adjustment with drugs having narrow therapeutic indices, such as aminoglycoside antibiotics. With the latter, serum concentrations are measured to assure attainment of therapeutic yet nontoxic levels (8). More... »

PAGES

1065-1078

Book

TITLE

Suki and Massry’s THERAPY OF RENAL DISEASES AND RELATED DISORDERS

ISBN

978-1-4757-6634-9
978-1-4757-6632-5

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-4757-6632-5_63

DOI

http://dx.doi.org/10.1007/978-1-4757-6632-5_63

DIMENSIONS

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