The kidney and drug kinetics
DOI:
https://doi.org/10.51481/amc.v39i2.604Keywords:
Farmacocinética, Insuficiencia renal, Eliminación renal, Dosificación de fármacosAbstract
Justification and objectives: The kidney plays a very important role in pharmacokinetics, specifically on the elimination of drugs. We review the basis of that process in order to understand the fundamental changes that can occur when the renal elimination is altered by multiple pathological or physiological factors. Under those situations, the health professional must know the events that can modify the pharmacological effect and the pratical ways to use the drugs safely and efficaciously in those patients.
Methods: this is a bibliographic review.
Results: the renal clearance of drugs is a complex process, which is determined and can be modified by multiple factors, including renal disease and aging. When those factors cause a significant change in the kidney's capacitiy to eliminate drugs, the physician must adjust the dose or the dosage intervals for drugs which are largely renally excreted; the purpose is to prescribe the adequate amount of drug to achieve the desired pharmacological effect without increasing the risk of toxicity caused by the accumulation of the drug or its metabolites. The most commonly used methods are based on the measured or estimated creatinine clearance, even though it has some limitations; this approach can be simplified by the DREM system (dosing in renopathy by easy to use multipliers).
Conclusion: it is essential to understand the kidney role on pharmacokinetics, in order to achieve a safe and correct prescription of drugs in the renal and geriatric patients.
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