Pharmacology & CKD: how chronic kidney disease and its complications alter drug response.
People with chronic kidney disease often live with many illnesses and complex treatment regimens. As the disease progresses, the number of drugs prescribed may increase substantially; by the time a patient is in stage 5, he may be taking 11 or more drugs daily. The effects of the disease on pharmacokinetics (drug absorption, metabolism, distribution, and elimination) and pharmacodynamics (a drug's mechanism of action and effects at the target site) further increase the potential for adverse drug reactions and drug toxicity. Nurses' roles in evaluating patients' responses to drugs and teaching about the risks involved are discussed.
Campoy
Sally
S
University of Colorado Health Sciences Center, School of Nursing, Denver, CO, USA. sfcampoy@msn.com
Elwell
Rowland
R
D018450:Disease Progression; D004347:Drug Interactions; D016903:Drug Monitoring; D004358:Drug Therapy / Q000451:nursing* / Q000523:psychology; D064420:Drug-Related Side Effects and Adverse Reactions; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism* / Q000451:nursing; D008657:Metabolic Clearance Rate / Q000187:drug effects; D009730:Nursing Assessment; D010349:Patient Compliance; D010353:Patient Education as Topic; D014018:Tissue Distribution / Q000187:drug effects