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Related Concept Videos

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions01:09

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

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Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
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Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

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

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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 Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

333
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
333
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

574
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.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

131
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Augmented Renal Clearance and How to Augment Antibiotic Dosing.

Iris H Chen1, David P Nicolau1

  • 1Center for Anti-Infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.

Antibiotics (Basel, Switzerland)
|July 15, 2020
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Summary

Augmented renal clearance (ARC), a condition in critically ill patients, involves faster kidney filtration. This requires adjusted antibiotic dosing to prevent treatment failure.

Keywords:
antibioticaugmented renal clearancecritical carepharmacodynamicspharmacokineticssubtherapeutic

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Area of Science:

  • Critical care medicine
  • Pharmacology
  • Nephrology

Background:

  • Augmented renal clearance (ARC) is common in critically ill patients.
  • It results from disease response and medical interventions.
  • ARC is defined as creatinine clearance > 130 mL/min/1.73 m².

Purpose of the Study:

  • To highlight the significance of ARC in critically ill patients.
  • To discuss the impact of ARC on antibiotic dosing.
  • To review existing research and identify future needs.

Main Methods:

  • Literature review of studies on ARC in critically ill patients.
  • Analysis of research on antibiotic pharmacokinetics in ARC.
  • Exploration of dosing strategies for common antibiotics.

Main Results:

  • ARC affects antibiotic efficacy due to increased renal clearance.
  • Conventional dosing may lead to subtherapeutic drug levels and treatment failure.
  • Studies have investigated dosing for piperacillin-tazobactam and vancomycin in ARC.

Conclusions:

  • ARC necessitates consideration in antibiotic selection and dosing for critically ill patients.
  • Optimized dosing strategies are crucial to ensure therapeutic success.
  • Further research is needed to refine management strategies for ARC.