Article ; Online: Drug-Induced Nephrotoxicity and Dose Adjustment Recommendations: Agreement Among Four Drug Information Sources.
International journal of environmental research and public health
2015 Volume 12, Issue 9, Page(s) 11227–11240
Abstract: Hospitalized patients require the use of a variety of drugs, many of which individually or in combination have the potential to cause kidney damage. The use of potentially nephrotoxic drugs is often unavoidable, and the need for dose adjustment should ... ...
| Abstract | : Hospitalized patients require the use of a variety of drugs, many of which individually or in combination have the potential to cause kidney damage. The use of potentially nephrotoxic drugs is often unavoidable, and the need for dose adjustment should be evaluated. This study is aimed at assessing concordance in information on drug-induced nephrotoxicity and dose adjustment recommendations by comparing four drug information sources (DRUGDEX(®), UpToDate(®), Medscape(®) and the Brazilian Therapeutic Formulary) using the formulary of a Brazilian public hospital. A total of 218 drugs were investigated. The global Fleiss' kappa coefficient was 0.265 for nephrotoxicity (p < 0.001; CI 95%, 0.211-0.319) and 0.346 for recommendations (p < 0.001; CI 95%, 0.292-0.401), indicating fair concordance among the sources. Anti-infectives and anti-hypertensives were the main drugs cited as nephrotoxic by the different sources. There were no clear definitions for qualitative data or quantitative values for dose adjustments among the four information sources. There was no advice for dosing for a large number of the drugs in the international databases. The National Therapeutic Formulary offered imprecise dose adjustment recommendations for many nephrotoxic drugs. Discrepancies among information sources may have a clinical impact on patient care and contribute to drug-related morbidity and mortality. |
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| MeSH term(s) | Anti-Infective Agents/toxicity ; Antihypertensive Agents/toxicity ; Brazil ; Drug Dosage Calculations ; Drug Information Services/standards ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Female ; Humans ; Kidney/pathology ; Kidney Diseases/chemically induced ; Kidney Diseases/prevention & control ; Male |
| Chemical Substances | Anti-Infective Agents ; Antihypertensive Agents |
| Language | English |
| Publishing date | 2015-09-09 |
| Publishing country | Switzerland |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ISSN | 1660-4601 |
| ISSN (online) | 1660-4601 |
| DOI | 10.3390/ijerph120911227 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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