these kinds of drugs, kidney dysfunction can also be used

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these kinds of drugs, kidney dysfunction can also be used

2017-09-26 16:41

It is well known that when renal dysfunction occurs, it is often necessary to reduce the dose or extend the dosing interval, and some nephrotoxic agents are not even available. However, some drugs have little effect on the kidney, and the dose of mild to moderate renal insufficiency can be adjusted without dose reduction, which can lead to a decrease in curative effect. So, what are the drugs, kidney dysfunction can also be used?
Penicillins and cephalosporins: Although penicillin is excreted through the kidneys, it is safe to use because of its high therapeutic index. Therefore, there is no reduction except for severe renal insufficiency, and the interval is only adjusted.
Moshe Shah Singh: only 20% of patients with renal excretion and impaired renal function had no significant change in pharmacokinetics.
General heparin: after a large number of intravenous injection, 50% of the prototype discharge, urinary heparin excretion through the kidneys, kidney function can not be reduced.
Class B: mainly through the stool, renal dysfunction can not be reduced.
Hua Falin: in the liver metabolism, after multiple pathways of metabolism, kidney dysfunction can not adjust the dose, but should pay attention to urinary and reproductive system bleeding, patients may not use.
Antiplatelet agents
Aspirin: excreted in the form of bound metabolites and free salicylic acid. Mild to moderate renal insufficiency can be adjusted without dosage.
Low GFR is still effective, patients with renal injury first choice, need to increase the dose. In patients with congestive heart failure and nephrotic syndrome, the oral absorption rate also decreases due to the edema of the intestinal wall, which should be given at the time of parenteral administration.
ACEI and ARB: renal excretion, renal insufficiency, starting with moderate doses, followed by blood pressure, renal function, and blood potassium adjusted doses. It has the function of protecting the kidney and is the first choice for the excretion of urinary protein >500 ~ 1000 mg/d in patients with chronic kidney disease.
Statins: these drugs and their metabolites are mainly eliminated by bile after liver and / or extrahepatic metabolism. There is no reduction in renal function, but kidney damage increases the risk of rhabdomyolysis.
Vitamin D: adjust doses according to PTH, 25-OH-, vitamin D, and serum phosphorus levels.
Glucocorticoids: metabolized to inactive metabolites, excreted by the kidneys, and generally not adjusted when they are functioning as renal insufficiency.
Immunosuppressive antibodies: they are not affected by renal function and can not be cleared by blood flow. They are mostly used after plasma exchange.
Glucosamine: safe to use, diabetics can use, and patients with renal insufficiency can be reduced.
Bisphosphonates: renal excretion is safe in patients with stage CKD2 and 3, and should be hydrated before use.

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