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Medication Dosing Errors in Hospitalized Patients with Renal ‎Impairment: A Study in Palestine

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Tue, 2014-07-01 11:20 — Abdel Naser Zaid
Journal Title, Volume, Page: 
Pharmacoepidemiology and Drug Safety Volume 16, Issue 8, pages 908–912
Year of Publication: 
2007
Link: 
http://onlinelibrary.wiley.com/doi/10.1002/pds.1412/abstract;jsessionid=B8EBE6ED...
Authors: 
Abed Al-Naser M. Zaid
College of Pharmacy, An-Najah National University, Nablus, Palestine
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
[email protected]
Samah W. Al-jabi
College of Pharmacy, An-Najah National University, Nablus, Palestine
Nidal A. Jaradat
College of Pharmacy, An-Najah National University, Nablus, Palestine
Iyad A. Sabri
College of Pharmacy, An-Najah National University, Nablus, Palestine
Adham S. Abu-Taha
College of Pharmacy, An-Najah National University, Nablus, Palestine
Samah A. Janem
College of Pharmacy, An-Najah National University, Nablus, Palestine
Waleed M. Sweileh
College of Pharmacy, An-Najah National University, Nablus, Palestine
Ansam F. Sawalha
Poison Control and Drug Information Center (PCDIC), An-Najah National University, Nablus, Palestine
Sa'ed H. Zyoud
Poison Control and Drug Information Center (PCDIC), An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

Reduced renal function requires dose adjustment for certain drugs to avoid toxicity. The aim of this study was to determine whether appropriate dosage adjustments were made for drugs that are nephrotoxic, excreted, or metabolized (TEM medications) by the kidney in patients with renal impairment.

METHODOLOGY:

A cross-sectional study of a group of hospitalized patients was carried out at Al-Watni governmental hospital, Nablus, Palestine. All patients with creatinine clearance </=59 ml/min were included in the analysis. Data regarding patients' clinical, laboratory findings and medications whether they were prescribed at hospital or at discharge were collected from patients' medical files. Evaluation of appropriate dosing was based on Physician Disk Reference (PDR). All data were collected for further research and subsequent statistical analysis using statistical package for social sciences (SPSS) for windows version 10.

RESULTS:

A total of 78 patients had calculated creatinine clearance </=59 ml/min. Those patients were prescribed a total of 1001 lines of prescription medication. Dosage adjustment was necessary for 193 TEM medications. Analysis of TEM medications with guidelines for adjustment indicated that 73.58%(142) were found to be inappropriate and 26.42% (51) were found to be appropriate. The most common inappropriate medications were ranitidine, antibiotics, and digoxin. Approximately 77.5% of the unadjusted medications were prescribed during hospitalization.

CONCLUSION:

In our study, a wide range of dosing errors was common among patients with renal impairment that was common during hospitalization. Continued medical education in the field of clinical pharmacokinetics is important for physicians.