Adjusting the dosage of medication in institutionalised elderly patients with renal failure

Montañés-Pauls, B.; Sáez-Lleó, C.; Martínez-Romero, G.

doi:10.1016/S2173-5085(09)70068-1

Farmacia Hospitalaria

ISSN: 1130-6343

Farmacia Hospitalaria (Farm Hosp) is the official publication of the Spanish Society of Hospital Pharmacists (SEFH), a professional and scientific organization that currently has about 4.351 members.

The Mission of Farm Hosp is to be the support for health professionals for expanding the influence of projects, publications, and training programs, and to promote the exchange of experiences.

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Fifty-two residents of 251 centres presented creatinine clearance lower than 30mL/ min. Forty-seven out of 74 pharmaceutical interventions were accepted. The drugs which were mainly used were: diuretics, antibiotics, anti-inflammatories, antiemetics, and ranitidine. Although the process of renal disease continued its course, in most cases the follow-up parameters of effectiveness and safety (in terms of renal toxicity) were maintained within the established limits.

Conclusion

The interventions carried out showed, in most cases, to be safe (renal toxicity) and effective, with some exceptions which required more individual follow-up.

Keywords:

Chronic renal failure

Pharmaceutical care

Nursing homes

Geriatrics

Resumen

Objetivo

Describir un programa de atención farmacéutica en ancianos con insuficiencia renal en 3 centros sociosanitarios de la Comunidad Valenciana.

Método

Estudio prospectivo de 9 meses de las intervenciones farmacéuticas realizadas, para evaluar la evolución de la función renal y la efectividad del ajuste posológico de fármacos con farmacocinética afectada por insuficiencia renal en pacientes con aclaramiento de creatinina inferior a 30ml/min.

Resultados

Cincuenta y dos residentes de los 251 valorados presentaron aclaramiento de creatinina inferior a 30ml/min. De las 74 intervenciones farmacéuticas realizadas, se aceptaron 47. Los fármacos mayormente implicados fueron: diuréticos, antibióticos, antiinflamatorios, antieméticos y ranitidina. Aunque el progreso de la enfermedad renal sigue su curso, en la mayoría de los casos los parámetros de seguimiento de la efectividad y la seguridad (en términos de toxicidad renal) se mantienen dentro de los límites establecidos.

Conclusión

Las intervenciones realizadas se muestran en la mayoría de los casos seguras (toxicidad renal) y efectivas, con alguna excepción, que requiere un seguimiento más individualizado.

Palabras clave:

Insuficiencia renal crónica

Atención farmacéutica

Sociosanitario

Geriatría

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References

[1.]

Manual de diagnóstico y terapéutica,

[2.]

J. Coresh, B.C. Astor, T. Greene, G. Eknoyan, A.S. Levey.

Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third national health and nutrition examination survey.

Am J Kidney Dis, 41 (2003), pp. 1-12

http://dx.doi.org/10.1053/ajkd.2003.50007 | Medline

[3.]

X. Fábregas Planas, C. Agustí Maragall, T. Gurrera Roig, A. Felip Benach.

Evaluación de la intervención farmacéutica en un programa de reajuste de dosis en pacientes con función renal alterada.

Farm Hosp, 27 (2003), pp. 28

[4.]

D.W. Cockroft, M.H. Gault.

Prediction of creatinine clearance from serum creatinine.

Nephron, 16 (1976), pp. 31-41

Medline

[5.]

Fundamentos teórico-prácticos de nutrición y dietética, 2nd Ed.,

[6.]

The Sanford guide to antimicrobial therapy, 32th ed.,

[7.]

Geriatric Dosage Handbook, 11th ed.,

[8.]

Opendatabase: Micromedex healthcare series. [Accessed June 6, 2005]. Available from: http://www.thomsonhc.com/home/dispatch/

[9.]

Consejo General de Colegios Oficiales de Farmacéuticos.

Catálogo de medicamentos.

Ministerio de Sanidad y Consumo, (2007),

[10.]

A.V. Chobanian, G.L. Barkis, H.R. Blacck, W.C. Cushman, L.A. Green, J.L. Izzo, et al.

Seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of hight blood pressure.

Hypertension, 42 (2003), pp. 1206-1252

http://dx.doi.org/10.1161/01.HYP.0000107251.49515.c2 | Medline

[11.]

Estudios y guías SEN: EPIRCE. Available from: www.senefro.org

[12.]

J. Martínez, M. Guardino, M. Ripollés, H. Julio, M. Lladó, L. Palau, et al.

Ajuste posológico en pacientes con insuficiencia renal. Incorporación a la actividad del Servicio de Farmacia.

Farm Hosp, 27 (2003), pp. 27

[13.]

A. Valladolid Walsh, A. Rubio Fernández, M. Clemente Andújar, C. García Gómez, M.R. Garrigues Sabastiá, P. Yáñez Avendaño, et al.

Ajuste posológico de fármacos en insuficiencia renal: situación actual y necesidad de intervención.

Farm Hosp, 27Suppl1 (2003), pp. 26

[14.]

E. Odena Estradé, F. Pastor Solernou, M.Q. Gorgas Torner.

Atención Farmacéutica en los problemas relacionados con los medicamentos en enfermos hospitalizados.

Farm Hosp, 27 (2003), pp. 280-289

Medline

[15.]

C. Pardo Gracia, M. Sagales Torra, M. Oms Arias, M.P. Mas Lombarte.

Evaluación de la atención farmacéutica en la prescripción de medicamentos.

Farm Hosp, 19 (1995), pp. 133-135

[16.]

D. Campany, S. Grau, J. Monterde, E. Salas, A. Carmona, M. Marín, et al.

Análisis de las intervenciones farmacéuticas realizadas a través del sistema informatizado de dispensación en dosis unitaria.

Farm Hosp, 22 (1998), pp. 11-15

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