How does chronic kidney disease CKD alter the effects of medications in the patient?

In general, protein binding of acidic drugs (including warfarin, phenytoin, ceftriaxone, and furosemide) is decreased in patients with CKD due to structural changes of protein binding sites, displacement by endogenous compounds, and decreased serum albumin concentration.

How does kidney disease affect medication administration?

Medications are an important source of medical errors, and kidney disease is a thoroughfare of factors threatening safe administration of medicines. Principal among these is reduced kidney function because almost half of all medications used are eliminated via the kidney.

What medications are bad for chronic kidney disease?

What medications to avoid with kidney disease

Pain medications also known as nonsteroidal anti-inflammatory drugs (NSAIDs)
Proton pump inhibitors (PPIs)
Cholesterol medications (statins)
Antibiotic medications.
Diabetes medications.
Antacids.
Herbal supplements and vitamins.
Contrast dye.

What are drug related problems?

Drug-related problems (DRPs), defined as ‘an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes’,1 constitute a frequent safety issue among hospitalised patients leading to patient harm and increased healthcare costs.

How does renal failure affect the metabolism of medications?

Chronic renal failure (CRF) has been shown to significantly reduce the nonrenal clearance and alter bioavailability of drugs predominantly metabolized by the liver and intestine.

What medications cause renal failure?

Many medicines can cause acute kidney injury (acute renal failure), such as:

Antibiotics.
Some blood pressure medicines.
Medicines used for cancer treatment (chemotherapy).
Dyes (contrast media).
Illegal drugs.
Medicines used to treat HIV.
Nonsteroidal anti-inflammatory drugs.
Ulcer medicines.

What are the factors affecting drug action?

Factors influencing drug effects

Type of drug.
Quantity of drug used.
Method of drug use.
Time taken to consume.
Tolerance.
Gender, size and amount of muscle.
Use of other psycho-active drugs.
Mood or attitude.

What medications affect creatinine levels?

Several drugs, such as cimetidine, trimethoprim, corticosteroids, pyrimethamine, phenacemide, salicylates and active vitamin D metabolites, have been reported to increase plasma creatinine without influencing its glomerular filtration.

When can medication errors occur?

Medication errors can occur throughout the medication-use system. Such as, when prescribing a drug, upon entering information into a computer system, when the drug is being prepared or dispensed, or when the drug is given to or taken by a patient.

What is the high risk medication?

High risk medicines (HRMs) are medications that have an increased risk of causing significant patient harm or death if they are misused or used in error.

How does chronic kidney disease affect medication excretion?

Chronic kidney disease (CKD) strongly influences drug excretion. Many medications require dosage adjustments in kidney disease in order to ensure efficacy and prevent toxicity. Pharmacologic agents may have active metabolites that are renally excreted in addition to unchanged drug.

What are the adverse effects of medication-related CKD?

Adverse medication-related outcomes in CKD can be classified as those leading to kidney damage, including AKI, accelerated kidney function loss, and ESKD, as well as other metabolic complications, including hyperkalemia, hypercalcemia, hypoglycemia, and bleeding, among others ( 8 ).

What is chronic kidney disease (CKD)?

Chronic kidney disease (CKD) is a complex disease impacting more than twenty million individuals in the United States. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia and metabolic bone disease.

How does uremia in CKD affect drug treatment outcomes?

Uremia in CKD can also alter the volume of distribution of plasma/tissue protein-bound drugs, which can significantly affect therapeutic and safety outcomes of narrow therapeutic range medications ( e.g., digoxin) ( 11 ).