Management of Renally Dosed Medications

Conditions such as Renal Dysfunction and Chronic Kidney Disease (CKD) can alter the renal elimination of certain medications, a problem that can lead to supratherapeutic concentrations, that can alter the efficacy and/or increase toxicity. Medication errors in patients with reduced creatinine clearance are both harmful and costly. Drugs that are nephrotoxic or cleared by the kidneys contribute to a significant number of preventable adverse drug events (PADEs), each year.  However, at Hospital Pharmacy Management (HPM), we find that most PADEs can be safely intercepted. 

Creatinine Clearance

Creatinine clearance is widely used by clinicians to evaluate the renal function of patients. Using tools such as the Cockroft–Gault formula, dosage adjustments based on renal function are recommended for many medications. The most common recommendation is often to reduce the dose or expand the dosing interval or use both approaches simultaneously. When Hanlon et al. studied clearance of renally cleared medications, they observed that 1 in 10 older patients had a potentially inappropriate prescription of primarily renally cleared medications.  

Medication Errors

Unfortunately, neither medication errors nor reduced creatinine clearance are uncommon in hospitals. When medication errors occur they usually result in adverse drug events (ADEs). ADEs can prolong the patient’s length of stay (LOS), increase care costs or even result in death. Telepharmacy can help to overcome medication errors by offering 24-hour pharmacist support and monitoring of patients on renally cleared medications. 

How HPM Can Help

It can be challenging to keep on top of patients and perform drug therapy monitoring. But, with HMP you have the potential to greatly improve the provision of pharmacy services at your hospital. The use of telepharmacy translates not only to operational, and financial benefits but more importantly, improvements in patient safety and quality of care. We assess patients, evaluate medication therapies and develop medication care plans with round-the-clock coverage. The result is the delivery of optimized patient outcomes. If you would like to witness the value of telepharmacy firsthand, contact Hospital Pharmacy Management today. 

With HMP you get medication order screening and verification to help solve some of the most vexing problems associated with the management of renally dosed medications.