Renal - Drugs that alter urinary function and promote kidney function Flashcards
What are the major routes of drug excretion?
Intestine, bile (EHC), and kidneys.
Which organ is responsible for excreting all water-soluble substances?
The kidney.
Name the three fundamental processes of renal excretion.
Glomerular filtration, tubular reabsorption, and tubular secretion.
What factors affect renal excretion?
Blood flow to kidney, urinary pH, age, and disease.
Why is renal clearance significant for drugs?
It is important for drugs with a narrow therapeutic index to prevent toxicity.
What happens when renal clearance is impaired?
It increases the half-life of drugs, leading to potential toxicity.
What should be done to drug dosages in renal impairment?
Dosages need to be modified to avoid accumulation and toxicity.
What are the two ways of dose adjustment in renal impairment?
Prolong dosing intervals or decrease the dose without changing dosing intervals.
When is dose adjustment required for drugs?
When creatinine clearance is below 60 ml/min.
What is a minor dose adjustment in renal impairment?
When creatinine clearance is 30-60 ml/min.
What is a major dose adjustment in renal impairment?
When creatinine clearance is less than 15 ml/min.
Which antibiotics require dose adjustment in renal impairment?
Aminoglycosides, vancomycin, ceftazidime, cefepime, cephazolin, ciprofloxacin, piperacillin, imipenem, carbapenems, sulfamethoxazole.
Name antifungal drugs that require dose adjustment.
Fluconazole, itraconazole.
Which antiviral drugs require dose adjustment in renal impairment?
Acyclovir, famciclovir, valacyclovir.
List hypoglycemic agents that need dose adjustment in renal impairment.
Metformin, glibenclamide, glimepiride, gliptins, insulin.
Which cardiac drugs require dose adjustment?
Digoxin, atenolol, sotalol.
Name psychotropics and anticonvulsants requiring dose adjustment.
Lithium, gabapentin, levetiracetam, topiramate, vigabatrin, SSRIs.
Which NSAIDs and opioids require dose adjustment?
Aspirin, paracetamol, coxibs, morphine, codeine, pethidine.