Patients with renal failure should be special care of taking drugs in order to avoid the burden of drugs to increase the kidneys and possible damage to the kidneys.Because of renal failure patients with the reaction of the drug not same with the general normal, so taking drugs should pay attention to the physician must know that they have the case of renal failure in order to make the appropriate dose adjustment of the drug.
Why should patients with kidney failure be particularly careful when using drugs? Why should the prescription adjust the dose? There are several reasons:
the change in absorption of drugs
Renal failure patients often accompanied by gastrointestinal discomfort or vomiting, changes in the drug stay in the gastrointestinal time, shorten the absorption time, affecting the final absorption of the dose. For example: the best absorption of iron in the fasting, but will make the stomach irritation and feel discomfort, in order to reduce its stimulation of the stomach, the pharmaceutical factory to produce a slow release of the ingot, swallowed in the gastrointestinal slow Slow release of iron, reduce the stimulus. This is ideal, but if the patients suffering from renal failure have vomiting or diarrhea, the iron is not completely released out of the body, what can actually be absorbed is less than expected.
the distribution of drugs in the body and metabolism is different from normal
Renal failure will affect the plasma protein and drug binding rate, change the drug in the blood and tissue distribution between the situation, in general, plasma protein and drug binding rate decreased, will increase the intensity of drug action, because the unbound drug concentration increased, the role is also enhanced. Relative to the free drug is also relatively easy to be the body of the enzyme metabolism, it does not promote the metabolism of drugs it? But the situation is not necessarily the case! Due to renal failure will change the concentration of various enzymes in the body, each enzyme changes are not the same situation, so when doing the drug dose adjustment, depending on the inpidual circumstances to deal with. For example, when diabetic patients have kidney disease, with the deterioration of renal function, some patients become more easily controlled blood sugar, and some patients even mistakenly believe that "diabetes is cured," In fact, this is because the main metabolism of human insulin is in the kidneys, when the kidneys are diseased, the decrease in insulin metabolism increases the amount of residual but increases, and blood sugar is easier to control. Followed by the new kidney glycation is the source of blood sugar, kidney is not good when this part of the role of reduction, of course, blood sugar will be reduced. If the patient then taking oral hypoglycemic agents, due to oral hypoglycemic agents are also metabolized by the kidneys, decreased renal function also reduce the excretion of drugs, increased blood concentration increased, the patient is very easy because of low blood sugar and fainted, or even fatal risk.
the excretion of drugs reduced
Because the excretion of the kidney function is worse than normal, the excretion of drugs, of course slower than the average, the drug will be easy to accumulate in the body caused by toxicity, especially long-term use of drugs, but must pay attention. For example: muscle relaxant Baclofen, renal failure patients often produce disturbance of consciousness, the patient becomes more than anxious, lost the usual courteous attitude. The reason is that this drug must be discharged by the kidneys, renal function decreased when the drug discharge is also reduced, so that the relative increase in blood concentration, the role of enhanced, and Baclofen can inhibit the central nervous neurons in the suppression of neurons, is tantamount to the role of self-inhibition , So there are a variety of inappropriate behavior.
In short, the impact of drug absorption, metabolism and excretion of a lot of factors, and the degree of renal failure on the impact of various drugs are not consistent, for their own health considerations, not arbitrarily increase or decrease the dose of drugs, so as to avoid too much or less,loss the meaning of the drug.