Dose Adjustment For Patients With Renal Impairment

Adjustment of the initial dose (or where necessary the priming or loading dose, see p. 117) is generally unnecessary, for the volume into which the drug has to distribute should be the same in the uraemic as in the healthy subject.

Adjustment of the maintenance dose involves either reducing each dose given or lengthening the time between doses.

Special caution is needed when the patient is hypoproteinaemic and the drug is usually extensively plasma protein bound, or in advanced renal disease when accumulated metabolic products may compete for protein binding sites; particular care is required in the early stages of dosing until response to the drug can be gauged.

General rules

1. Drugs that are completely or largely excreted by the kidney or drugs that produce active, renally-

TABLE 26.1 Drug tij (h) with normal and with severely impaired renal function

Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

Get My Free Ebook


Post a comment