In kidney insufficiency period, how should kidney patients use medicine?
1. drug selection
Choose drugs that are not primarily excreted by the kidneys as far as possible. If the drugs and their metabolites are not excreted by the kidneys, the dose need not be adjusted. If the main renal excretion, the dose should be adjusted.
Try to choose drugs with low renal toxicity. Check for medications in use. Reduce the variety of drugs and stop unnecessary drugs. Determine the possible interactions between drugs.
2. Judge the degree of renal function damage
Stage endogenous creatinine clearance rate CCr (ml/min) 8
Normal period: 80~120
renal insufficiency compensatory period 80~51
Renal insufficiency compensatory period is 50~20
Renal failure period 19~10
The Uremia period is less than 10
3. Determine the load dose
Due to the increase of extracellular fluid in patients with renal insufficiency, ideal body weight is often used to estimate its loading dose.
4. Determine maintenance dose
At the same dose, the interstitial period was changed. The interstitial period of administration remains unchanged, and each dose is changed. Or change the profile interval and each dose at the same time.
5. Under renal dysfunction
Use drugs that are effective at low concentrations or less toxic;
Avoid drugs with long half-life;
The use of drugs with renal toxicity, such as contrast agents, cyclosporin, glucosamine, etc.
Choose drugs that are not primarily excreted by the kidneys as far as possible. If the drugs and their metabolites are not excreted by the kidneys, the dose need not be adjusted. If the main renal excretion, the dose should be adjusted.
Try to choose drugs with low renal toxicity. Check for medications in use. Reduce the variety of drugs and stop unnecessary drugs. Determine the possible interactions between drugs.
2. Judge the degree of renal function damage
Stage endogenous creatinine clearance rate CCr (ml/min) 8
Normal period: 80~120
renal insufficiency compensatory period 80~51
Renal insufficiency compensatory period is 50~20
Renal failure period 19~10
The Uremia period is less than 10
Due to the increase of extracellular fluid in patients with renal insufficiency, ideal body weight is often used to estimate its loading dose.
4. Determine maintenance dose
At the same dose, the interstitial period was changed. The interstitial period of administration remains unchanged, and each dose is changed. Or change the profile interval and each dose at the same time.
5. Under renal dysfunction
Use drugs that are effective at low concentrations or less toxic;
Avoid drugs with long half-life;
The use of drugs with renal toxicity, such as contrast agents, cyclosporin, glucosamine, etc.
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