Next Article in Journal
Clinical Pharmacy Activities in Swiss Hospitals: How Have They Evolved from 2013 to 2017?
Next Article in Special Issue
Safety and Efficacy of Direct Oral Anticoagulants for Atrial Fibrillation in Patients with Renal Impairment
Previous Article in Journal
Physicians’, Nurses’ and Pharmacists’ Perceptions of Determinants to Deprescribing in Nursing Homes Considering Three Levels of Action: A Qualitative Study
Open AccessOpinion

Drug Dosing Considerations in Critically Ill Patients Receiving Continuous Renal Replacement Therapy

1
School of Pharmacy, Loma Linda University, Loma Linda, CA 92350, USA
2
School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(1), 18; https://doi.org/10.3390/pharmacy8010018
Received: 31 December 2019 / Revised: 4 February 2020 / Accepted: 4 February 2020 / Published: 7 February 2020
(This article belongs to the Special Issue Pharmacokinetics of Drugs and Dosing in Kidney Disease)
Acute kidney injury is very common in critically ill patients requiring renal replacement therapy. Despite the advancement in medicine, the mortality rate from septic shock can be as high as 60%. This manuscript describes drug-dosing considerations and challenges for clinicians. For instance, drugs’ pharmacokinetic changes (e.g., decreased protein binding and increased volume of distribution) and drug property changes in critical illness affecting solute or drug clearance during renal replacement therapy. Moreover, different types of renal replacement therapy (intermittent hemodialysis, prolonged intermittent renal replacement therapy or sustained low-efficiency dialysis, and continuous renal replacement therapy) are discussed to describe how to optimize the drug administration strategies. With updated literature, pharmacodynamic targets and empirical dosing recommendations for commonly used antibiotics in critically ill patients receiving continuous renal replacement therapy are outlined. It is vital to utilize local epidemiology and resistance patterns to select appropriate antibiotics to optimize clinical outcomes. Therapeutic drug monitoring should be used, when possible. This review should be used as a guide to develop a patient-specific antibiotic therapy plan. View Full-Text
Keywords: antibiotics; drug dosing; acute kidney injury; continuous renal replacement therapy; pharmacokinetics; pharmacodynamics antibiotics; drug dosing; acute kidney injury; continuous renal replacement therapy; pharmacokinetics; pharmacodynamics
Show Figures

Figure 1

MDPI and ACS Style

Jang, S.M.; Infante, S.; Abdi Pour, A. Drug Dosing Considerations in Critically Ill Patients Receiving Continuous Renal Replacement Therapy. Pharmacy 2020, 8, 18.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop