Tranquilizers, analgetics and antidepressants in patients treated with hemodialysis

Tranquilizers, analgetics and antidepressants are applied in different ranges in the treatment of patients on hemodialysis. Due to many different pharmacokinetic properties, no perfect rules for dosage in acute or chronic hemodialysis exist. Adequate applicable drugs without adaptation disregarding different states of renal failure are such with predominate hepatic metabolism and elimination or with inactive metabolites. In the management of acute renal failure, usually in connection with multiple organic disorders, a nonschematic, individually adapted therapy is indicated. In some substances, therapy can be determined by control of plasma concentration levels, in other drugs dosage is possible exclusively according to clinical effects. Substances with side effects on coagulation or acid-base equilibrium should be avoided. It is recommendable to get well acquainted with one substance out of each group in order to avoid polypragmasy.