Drugs and the kidney

Le résumé fourni par la source

Always verify the recommended dose and dosing schedule when prescribing for a patient with renal impairment. Ask yourself, ‘Is the drug still warranted, given the potential increased risk?’. Renal impairment may alter the sensitivity of target tissue to the effects of drugs. Examples: higher incidence of statin-induced myopathy, more pronounced effect of antiplatelet drugs, increased sensitivity to benzodiazepines, and increased risk of hyperkalaemia with potassium-sparing diuretics. Renal impairment influences the pharmacokinetics of most drugs to some degree. Understanding why can help select drugs, doses, and dosing intervals that achieve therapeutic plasma concentrations but avoiding toxicity. Absorption. Describes the passage of drug from site of administration into the plasma volume. Renal impairment may affect oral administration and enteral absorption via alterations in: Distribution. Measures the (theoretical) volume (Vd) occupied by the total amount (Q) of drug, assuming uniform concentration (Cp) in all body compartments (Vd = Q / Cp). Several parameters are subject to change in renal insufficiency.

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