Abstract

Prospective Evaluation of Drug Prescribing and Improvement of Drug Safety in Renal Failure Patients

Hygeia.J.D.Med.6 (2) 2014; 25-35.

Manjula Devi A. S, Bittu Thomas, Annu Joseph, Kavuri Sravani.

College of Pharmacy, SRIPMS, Sri Ramakrishna Hospital Campus, Coimbatore, Tamilnadu, India -641044.

Plan: To assess the incidence of inappropriate dosing of renally excreted drugs in hospitalized patients with renal impairment.

Preface: Inappropriate dosing in patients with renal dysfunction can cause drug accumulation and toxicity.

Method: Creatinine clearance or estimated glomerular filtration rate of patients with serum creatinine greater than 1.7 mg% was calculated using Cockroft-Gault equation and Modified Diet in Renal Disease equation respectively. Dose of all potentially nephrotoxic drugs was evaluated using the published drug dosing guidelines and the new dose or dosing interval was recommended based on the patient’s individual degree of renal impairment. 

Outcome: Five hundred and six drugs in 50 patients were evaluated of which the dosages of 88 (17.39%) drugs were not adjusted at the time of prescribing. Most of the drugs requiring dose adjustment were antibiotics (39.77%) and antihypertensives (14.77%). About 27% of the drugs were to be avoided strictly.

Conclusion: Drug dosing evaluation and concurrent feedback mechanism by the pharmacist improve drug safety in patients with renal impairment.

Keywords: Renal impairment, Creatinine clearance, Dosage adjustment, Drug safety.

Received: 16 August 2014,   Revised: 25 August 2014, Accepted: 30 August 2014, Available online: 10 October 2014

Manjula Devi A. S.*, Bittu Thomas, Annu joseph, Kavuri Sravani. . Prospective evaluation of drug prescribing and improvement of drug safety in renal failure patients. Hygeia.J.D.Med 2014; 6(2):25-35. Available from http://www.hygeiajournal.com / Article ID-Hygeia.J.D.Med/133/14.doi:10.15254/H.J.D.Med.6.2014.133.