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Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

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In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
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Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Renal Drug Excretion: Overview01:15

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As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
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Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
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Renal Drug Excretion: Tubular Reabsorption01:25

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Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
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Using simplistic simulations to enhance learning in a nephrology pharmacotherapeutics module.

Yen H Dang1

  • 1Assistant Professor of Pharmacy Practice, University of Maryland Eastern Shore, School of Pharmacy and Health Professions, One College Backbone Road, 210 Somerset Hall, Princess Anne, MD 21853, United States.

Currents in Pharmacy Teaching & Learning
|December 14, 2017
PubMed
Summary

Pharmacy students who participated in a nephrology simulation showed improved learning outcomes and higher exam scores. This active-learning approach enhanced their real-world knowledge and attitudes toward the subject.

Keywords:
DialysisElectrolytesFluidsNephrologySimulation

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Area of Science:

  • Pharmacy Education
  • Nephrology Therapeutics
  • Simulation-Based Learning

Background:

  • Nephrology pharmacotherapeutics modules are crucial for pharmacy students.
  • Traditional teaching methods may not fully engage students in complex topics like electrolyte imbalances and dialysis.
  • Active learning strategies can enhance understanding and retention of critical concepts.

Purpose of the Study:

  • To assess the impact of a simulation exercise on pharmacy students' learning in a nephrology module.
  • To evaluate student attitudes towards simulation-based learning in pharmacotherapeutics.
  • To determine if simulation improves academic performance in nephrology.

Main Methods:

  • Second-year pharmacy students engaged in a two-part simulation covering electrolyte imbalances and dialysis.
  • Anonymous surveys (five-point Likert scale) measured student attitudes and perceived value of the simulation.
  • Module exam scores were compared between students who participated in the simulation and those who did not.

Main Results:

  • 65 students completed the simulation activity.
  • 78% of students found the simulation a valuable learning experience.
  • Students who participated in the simulation achieved higher exam scores (p < 0.01).

Conclusions:

  • Simulation exercises positively influence pharmacy students' attitudes and learning in nephrology.
  • This active-learning method effectively enhances knowledge acquisition and academic performance.
  • Simulation is a valuable tool for pharmacy education, particularly in complex pharmacotherapeutic areas.