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Dose adjustment in renal failure NM.pptx
1. Dose adjustment in renal failure
1. LOADING DOSE
Loading dose depends on apparent volume of distribution.
Loading dose is not altered by apparent volume of distribution in
normal as well as patients with renal failure.
2. MAINTANENCE DOSE
Maintenance dose depends on clearance
In renal impairment patients total body clearance is decreased which in
turn decrease excretion.
2. โข Fraction of normal renal function remaining in renal impaired patients
is estimated from CLcr.
3. DISTRIBUTION
Distribution is altered with the patients with renal failure
Change in fluid balance and drug protein binding
Decrease in plasma protein binding of weak acidic drug but
of weak basic drug is less affected
Increase free fraction of drug so volume of distribution
increases
Elimination half life is increased
4. Steps to adjust drug dose regimen in renal
failure
1. Take history and clinical information
take past medical
Take past medical history.
Current laboratory information and clinical
information.
2. Estimation of glomerular filtration rate
