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10.1007/s00228-016-2113-2 http://scihub22266oqcxt.onion/10.1007/s00228-016-2113-2 C5110609!5110609 !27568310     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27568310 &cmd=llinks): Failed to open stream: HTTP request failed! 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Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice |pdf=|usr=}}{{27568310 }} gab.com Text Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice JO: Eur J Clin Pharmacol http://www.kidney.de/pget.php?&tw=1&pmid=27568310 #FOAvip PURPOSE: The use of estimated glomerular filtration rate (eGFR) in daily clinical practice. METHODS: eGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a serum creatinine testing is ordered. In this paper, we will discuss how to use eGFR knowing the limitations of serum creatinine-based formulas. RESULTS: Before starting a renally excreted drug, an equally effective drug which can be used more safely in patients with renal impairment should be considered. If a renally excreted drug is needed, the reliability of the eGFR should be assessed and when needed, a 24-h urine creatinine clearance collection should be performed. After achieving the best approximation of the true GFR, we suggest a gradual drug dose adaptation according to the renal function. A different approach for drugs with a narrow therapeutic window (NTW) is recommended compared to drugs with a broad therapeutic window. For practical purposes, a therapeutic window of 5 or less was defined as a NTW and a list of NTW drugs is presented. Considerations about the drug dose may be different at the start of the therapy or during the therapy and depending on the indication. Monitoring effectiveness and adverse drug reactions are important, especially for NTW drugs. Dose adjustment should be based on an ongoing assessment of clinical status and risk versus the benefit of the used regimen. CONCLUSION: When determining the most appropriate dosing regimen serum creatinine-based formulas should never be used naively but always in combination with clinical and pharmacological assessment of the individual patient. Twit Text FOAVip Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice ????Eur J Clin Pharmacol http://www.kidney.de/pget.php?&tw=1&pmid=27568310 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27568310 #FOAvip English Wikipedia <ref>{{Cite pmid|27568310 }}</ref> Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice #MMPMID27568310 Eppenga WL ; Kramers C ; Derijks HJ ; Wensing M ; Wetzels JF ; De Smet PA Eur J Clin Pharmacol 2016[Dec]; 72 (12 ): 1433-1439 PMID27568310 show ga PURPOSE: The use of estimated glomerular filtration rate (eGFR) in daily clinical practice. METHODS: eGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a serum creatinine testing is ordered. In this paper, we will discuss how to use eGFR knowing the limitations of serum creatinine-based formulas. RESULTS: Before starting a renally excreted drug, an equally effective drug which can be used more safely in patients with renal impairment should be considered. If a renally excreted drug is needed, the reliability of the eGFR should be assessed and when needed, a 24-h urine creatinine clearance collection should be performed. After achieving the best approximation of the true GFR, we suggest a gradual drug dose adaptation according to the renal function. A different approach for drugs with a narrow therapeutic window (NTW) is recommended compared to drugs with a broad therapeutic window. For practical purposes, a therapeutic window of 5 or less was defined as a NTW and a list of NTW drugs is presented. Considerations about the drug dose may be different at the start of the therapy or during the therapy and depending on the indication. Monitoring effectiveness and adverse drug reactions are important, especially for NTW drugs. Dose adjustment should be based on an ongoing assessment of clinical status and risk versus the benefit of the used regimen. CONCLUSION: When determining the most appropriate dosing regimen serum creatinine-based formulas should never be used naively but always in combination with clinical and pharmacological assessment of the individual patient. |*Glomerular Filtration Rate [MESH] |*Medication Therapy Management [MESH] |Creatinine/*blood [MESH] |Humans [MESH]Drug therapy management in patients with renal impairment: how to use (epmc).pdf DeepDyve Pubget Overpricing