肾功能损伤常用药物教案.pdfVIP

Commonly prescribed medications in renal impairment Christine Sluman Renal Services Pharmacist Aims and objectives Aim: • To introduce the audience to common medications prescribed in real patients After the session you should be able to: • Briefly describe the role of the kidneys • Name common causes of renal problems and describe some complications of renal disease • Identify common medicines used in the treatment of kidney disease and why these are used • Identify high risk medications such as heparin Topics to be covered • Kidney function and renal impairment • Water tablets (diuretics) • Hypertension • Cardiovascular medications • Renal anaemia • Calcium and phosphate management • Anticoagulation • Antibiotics • Other medications • How you can help! What do the kidneys do? • Filter the blood to remove waste products • Remove excess fluid • Help control blood pressure • Produce hormones and chemicals which – Help production of red blood cells – Maintain healthy bones • Different stages of renal impairment (mild to end-stage) What causes renal impairment? • Pre-renal - reduced blood supply to kidneys: sepsis, CCF, haemorrhage, dehydration, diuretics/ACEi • Post-renal (blockage): i.e prostate • Renal: autoimmune disease (lupus, vasculitis) • Drugs! • Diabetes • High blood pressure Diuretics • Commonly frusemide and bumetanide • Used to help the kidneys remove extra fluid • Best taken in the morning/lunchtime • May see large doses in patients with advanced renal failure (i.e 250-500mg frusemide) • May continue even if patent on dialysis – As long as still PU’s - every little helps! – Once patient anuric then stop Hypertension • Common in renal impairment