TY - CHAP
T1 - Drug Dose Adjustment in Dialysis Patients Admitted in Clinics Other Than Internal Medicine
AU - Y., Solak
AU - Z., Biyik
AU - A., Gaipov
AU - M., Kayrak
AU - H., Ciray
AU - A., Cizmecioglu
AU - H.Z., Tonbul
PY - 2016
Y1 - 2016
N2 - Many drugs that are administered during hospitalization are metabolized or excreted through kidneys, consequently require dosage adjustment. We aimed to investigate inappropriate prescription of drugs requiring renal dose adjustment (RDA) in various surgical and medical inpatient clinics. We retrospectively determined dialysis patients hospitalized between January 2007 and December 2010. Inpatient clinics, including cardiology, pulmonary medicine, neurology, infectious diseases (medical clinics) and cardiovascular surgery, orthopedics, general surgery, obstetrics and gynecology, and neurosurgery (surgical clinics), were screened via electronic database. Total and RDA medications were determined. RDA drugs correctly adjusted to creatinine clearance were labeled as RDA-A (appropriate), otherwise as RDA-I (inappropriate). Renal doses of RDA medications were based on the "American College of Physicians Drug Prescribing in Renal Failure, fifth Edition." Two hundred seventeen hospitalization records of 172 dialysis patients (92 men and 80 women) were included in the analysis. Mean age of patients was 59.4 +/- 14.6 years, and the mean hospitalization duration was 8.5 +/- 7.8 days. In total, 247 (84.3%, percentage in drugs requiring dose adjustment) and 175 (46.2%) drugs have been inadequately dosed in surgical and medical clinics, respectively. The percentage of patients to whom at least 1 RDA-I drug was ordered was 92% and 91.4% for surgical and medical clinics, respectively (P > 0.05). Nephrology consultation numbers were 8 (7.1%) in surgical and 32 (30.4%) in medical clinics. The most common RDA-I drugs were aspirin and famotidine. A significant portion of RDA drugs was ordered inappropriately both in surgical and medical clinics. Nephrology consultation rate was very low. Measures to increase physician awareness are required to improve results. Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.
AB - Many drugs that are administered during hospitalization are metabolized or excreted through kidneys, consequently require dosage adjustment. We aimed to investigate inappropriate prescription of drugs requiring renal dose adjustment (RDA) in various surgical and medical inpatient clinics. We retrospectively determined dialysis patients hospitalized between January 2007 and December 2010. Inpatient clinics, including cardiology, pulmonary medicine, neurology, infectious diseases (medical clinics) and cardiovascular surgery, orthopedics, general surgery, obstetrics and gynecology, and neurosurgery (surgical clinics), were screened via electronic database. Total and RDA medications were determined. RDA drugs correctly adjusted to creatinine clearance were labeled as RDA-A (appropriate), otherwise as RDA-I (inappropriate). Renal doses of RDA medications were based on the "American College of Physicians Drug Prescribing in Renal Failure, fifth Edition." Two hundred seventeen hospitalization records of 172 dialysis patients (92 men and 80 women) were included in the analysis. Mean age of patients was 59.4 +/- 14.6 years, and the mean hospitalization duration was 8.5 +/- 7.8 days. In total, 247 (84.3%, percentage in drugs requiring dose adjustment) and 175 (46.2%) drugs have been inadequately dosed in surgical and medical clinics, respectively. The percentage of patients to whom at least 1 RDA-I drug was ordered was 92% and 91.4% for surgical and medical clinics, respectively (P > 0.05). Nephrology consultation numbers were 8 (7.1%) in surgical and 32 (30.4%) in medical clinics. The most common RDA-I drugs were aspirin and famotidine. A significant portion of RDA drugs was ordered inappropriately both in surgical and medical clinics. Nephrology consultation rate was very low. Measures to increase physician awareness are required to improve results. Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.
KW - drug dosage form
KW - hemodialysis patient
KW - internal medicine
KW - acetylsalicylic acid
KW - adult
KW - awareness
KW - cardiology
KW - cardiovascular surgery
KW - college
KW - communicable disease
KW - consultation
KW - creatinine clearance
KW - data base
KW - famotidine
KW - female
KW - general surgery
KW - gynecology
KW - hospital patient
KW - hospitalization
KW - human
KW - inappropriate prescribing
KW - information processing
KW - kidney failure
KW - major clinical study
KW - male
KW - nephrology
KW - neurology
KW - neurosurgery
KW - obstetrics
KW - orthopedics
KW - physician
KW - pulmonology
KW - surgery
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UR - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed18a&NEWS=N&AN=52749915
UR - http://www.mendeley.com/research/drug-dose-adjustment-dialysis-patients-admitted-clinics-other-internal-medicine-1
U2 - 10.1097/MJT.0b013e3182a4ef81
DO - 10.1097/MJT.0b013e3182a4ef81
M3 - Chapter
C2 - 23982697
SN - 1075-2765
T3 - American Journal of Therapeutics
SP - e68-e73
BT - American Journal of Therapeutics
PB - Lippincott Williams and Wilkins (E-mail: [email protected])
CY - Y. Solak, Nephrology Unit, Department of Internal Medicine, Karaman State Hospital, Karaman 70100, Turkey. E-mail: [email protected]
ER -