Artikel ; Online: Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice.
European journal of clinical pharmacology
2016 Band 72, Heft 12, Seite(n) 1433–1439
Abstract: Purpose: The use of estimated glomerular filtration rate (eGFR) in daily clinical practice.: Methods: eGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a ... ...
Abstract | Purpose: The use of estimated glomerular filtration rate (eGFR) in daily clinical practice. Methods: eGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a serum creatinine testing is ordered. In this paper, we will discuss how to use eGFR knowing the limitations of serum creatinine-based formulas. Results: Before starting a renally excreted drug, an equally effective drug which can be used more safely in patients with renal impairment should be considered. If a renally excreted drug is needed, the reliability of the eGFR should be assessed and when needed, a 24-h urine creatinine clearance collection should be performed. After achieving the best approximation of the true GFR, we suggest a gradual drug dose adaptation according to the renal function. A different approach for drugs with a narrow therapeutic window (NTW) is recommended compared to drugs with a broad therapeutic window. For practical purposes, a therapeutic window of 5 or less was defined as a NTW and a list of NTW drugs is presented. Considerations about the drug dose may be different at the start of the therapy or during the therapy and depending on the indication. Monitoring effectiveness and adverse drug reactions are important, especially for NTW drugs. Dose adjustment should be based on an ongoing assessment of clinical status and risk versus the benefit of the used regimen. Conclusion: When determining the most appropriate dosing regimen serum creatinine-based formulas should never be used naively but always in combination with clinical and pharmacological assessment of the individual patient. |
---|---|
Mesh-Begriff(e) | Creatinine/blood ; Glomerular Filtration Rate ; Humans ; Medication Therapy Management ; Renal Insufficiency/blood ; Renal Insufficiency/metabolism ; Renal Insufficiency/physiopathology |
Chemische Substanzen | Creatinine (AYI8EX34EU) |
Sprache | Englisch |
Erscheinungsdatum | 2016-12 |
Erscheinungsland | Germany |
Dokumenttyp | Journal Article |
ZDB-ID | 121960-1 |
ISSN | 1432-1041 ; 0031-6970 |
ISSN (online) | 1432-1041 |
ISSN | 0031-6970 |
DOI | 10.1007/s00228-016-2113-2 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
Volltext online
Zusatzmaterialien
Kategorien
Verfügbar in ZB MED Köln/Königswinter
Zs.A 672: Hefte anzeigen | Standort: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Über subito bestellen
Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.