What is the individual’s GFR? → no adjustment until <60ml/min (Cockcroft ‐Gault Equation)
Is the drug effective in the setting of a reduced GFR? → e.g. thiazide doesn't work
Is the drug safe in CKD? (metformin, bisphosphonates, meperidine)
Is the drug itself nephrotoxic? (aminoglycosides, amphotericin B, NSAIDS)
Is an immediate effect desired or needed? → loading dose will often be same but usually ↓ maintenance dose or ↑ interval to maintain the drug level at a safe therapeutic level
Is the drug extensively eliminated by the kidney? (aminoglycosides, penicillins, cephalosporins, digoxin, vancomycin, lithium)
Does the drug have an active / toxic metabolite that is renally eliminated? (meperidine)
Tags
#nephrology
Question
What is the 7 step approach to drugs in nephro?
Answer
?
Tags
#nephrology
Question
What is the 7 step approach to drugs in nephro?
Answer
What is the individual’s GFR? → no adjustment until <60ml/min (Cockcroft ‐Gault Equation)
Is the drug effective in the setting of a reduced GFR? → e.g. thiazide doesn't work
Is the drug safe in CKD? (metformin, bisphosphonates, meperidine)
Is the drug itself nephrotoxic? (aminoglycosides, amphotericin B, NSAIDS)
Is an immediate effect desired or needed? → loading dose will often be same but usually ↓ maintenance dose or ↑ interval to maintain the drug level at a safe therapeutic level
Is the drug extensively eliminated by the kidney? (aminoglycosides, penicillins, cephalosporins, digoxin, vancomycin, lithium)
Does the drug have an active / toxic metabolite that is renally eliminated? (meperidine)
Summary
status
not learned
measured difficulty
37% [default]
last interval [days]
repetition number in this series
0
memorised on
scheduled repetition
scheduled repetition interval
last repetition or drill
Details
No repetitions
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